JP2024511124A - Fastener cartridge with non-repetitive fastener rows - Google Patents

Abstract

A surgical device is provided having at least one rotational input screw within an end effector. A rotational input screw can extend through a central longitudinal portion of the end effector. End effectors include, for example, improved closure systems, firing systems, leverage and alignment mechanisms between staple cartridges and surgical devices, staple cartridges with multi-staple drivers, single firing knives and their lockouts/safeties. features and/or modified staple patterns. Certain components may be 3D printed components.

Description

The present invention relates to surgical instruments, and to surgical stapling and cutting instruments designed to staple and cut tissue, end effectors, and staple cartridges for use therewith, in various configurations.

Various features of the embodiments described herein, together with their advantages, may be understood by the following detailed description, taken in conjunction with the accompanying drawings.
1 is a perspective view of a surgical stapling instrument including a handle, a shaft assembly, and an end effector in accordance with at least one aspect of the present disclosure; FIG. 2 is a perspective view of an end effector and a portion of the shaft assembly of the surgical stapling instrument of FIG. 1, with the end effector shown in a linear or non-articulating configuration, in accordance with at least one aspect of the present disclosure; FIG. 2 is a perspective view of an end effector and a portion of the shaft assembly of the surgical stapling instrument of FIG. 1, with the end effector shown in an articulated configuration, in accordance with at least one aspect of the present disclosure; FIG. FIG. 2 is an exploded perspective view of a portion of the end effector and shaft assembly of the surgical stapling instrument of FIG. 1 in accordance with at least one aspect of the present disclosure. 2 is a cross-sectional elevational view of an end effector and a portion of the shaft assembly of the surgical stapling instrument of FIG. 1, with the end effector shown in an unfired clamp configuration, in accordance with at least one aspect of the present disclosure; FIG. FIG. 2 is a plan view of a portion of the end effector and shaft assembly of the surgical stapling instrument of FIG. 1 in accordance with at least one aspect of the present disclosure. 6 is a cross-sectional elevational view of the end effector and a portion of the shaft assembly of FIG. 1 taken along section line 6-6 of FIG. 6, with the end effector shown in an open configuration, in accordance with at least one aspect of the present disclosure; FIG. 7 is a cross-sectional elevational view of the end effector and a portion of the shaft assembly of FIG. 1 taken along section line 7-7 of FIG. 6, with the end effector shown in a clamped configuration, in accordance with at least one aspect of the present disclosure. FIG. FIG. 2 is a perspective view of a surgical stapling assembly including a shaft assembly and the end effector of FIG. 1, with the end effector attached to the shaft assembly via an articulation joint, in accordance with at least one aspect of the present disclosure. 10 is an exploded perspective view of the surgical stapling assembly of FIG. 9 in accordance with at least one aspect of the present disclosure. FIG. 10 is a cross-sectional elevational view of the surgical stapling assembly of FIG. 9 with the end effector shown in an unfired clamp configuration, in accordance with at least one aspect of the present disclosure. FIG. 2 is a perspective view of a surgical stapling assembly comprising a shaft assembly and the end effector of FIG. 1, the end effector being attached to the shaft assembly via an articulation joint, in accordance with at least one aspect of the present disclosure; FIG. FIG. 13 is an exploded perspective view of the surgical stapling assembly of FIG. 12 in accordance with at least one aspect of the present disclosure. 13 is a cross-sectional elevational view of the surgical stapling assembly of FIG. 12 with the end effector shown in an unfired clamp configuration, according to at least one aspect of the present disclosure. FIG. 2 is a perspective view of a surgical stapling assembly comprising a shaft assembly and the end effector of FIG. 1, the end effector being attached to the shaft assembly via an articulation joint, in accordance with at least one aspect of the present disclosure; FIG. FIG. 16 is an exploded perspective view of the surgical stapling assembly of FIG. 15 in accordance with at least one aspect of the present disclosure. 16 is a cross-sectional elevational view of the surgical stapling assembly of FIG. 15 with the end effector shown in an unfired clamp configuration, in accordance with at least one aspect of the present disclosure; FIG. FIG. 2 is a perspective view of a surgical end effector assembly including the end effector of FIG. 1 and a flexible firing drive system in accordance with at least one aspect of the present disclosure. FIG. 19 is an exploded perspective view of the surgical stapling assembly of FIG. 18 in accordance with at least one aspect of the present disclosure. FIG. 19 is a cross-sectional elevational view of the surgical end effector assembly of FIG. 18 showing the surgical end effector assembly in an unfired clamp configuration, in accordance with at least one aspect of the present disclosure. 1 is a perspective view of a robot controller according to at least one aspect of the present disclosure. FIG. 1 is a perspective view of a robotic arm cart for a robotic surgical system showing a manipulator on the robotic arm cart operably supporting a surgical tool in accordance with at least one aspect of the present disclosure; FIG. 23 is a side view of the manipulator and surgical grasping tool of the surgical arm cart of FIG. 22, in accordance with at least one aspect of the present disclosure. FIG. 1 is a perspective view of a staple cartridge according to various aspects of the present disclosure. FIG. 25 is a perspective view of a portion of the staple cartridge of FIG. 24 showing the triple driver in a firing configuration within the staple cartridge, according to various aspects of the present disclosure. FIG. FIG. 26 is a perspective view of the triple driver of FIG. 25 in accordance with various aspects of the present disclosure. FIG. 27 is a top view of the triple driver of FIG. 26 in accordance with various aspects of the present disclosure. 27 is a bottom perspective view of the triple driver of FIG. 26 in accordance with various aspects of the present disclosure. FIG. FIG. 3 is an elevational cross-sectional view of a portion of an end effector showing a staple cartridge with a portion of the staple cartridge hidden therein for illustrative purposes, in accordance with various aspects of the present disclosure. 30 is a detailed view of the end effector of FIG. 29, in accordance with various aspects of the present disclosure. FIG. FIG. 3 is an elevational cross-sectional view of a portion of an end effector including a staple cartridge therein, in accordance with various aspects of the present disclosure. FIG. 3 is a schematic illustration of a triple driver showing the modified geometry in dashed lines and the relative positioning of the rotary drive screw in phantom lines, in accordance with various aspects of the present disclosure. FIG. 3 is a bottom perspective view of a cartridge body, with a portion hidden for illustrative purposes, in accordance with various aspects of the present disclosure. 34 is a detailed view of a portion of the cartridge body of FIG. 33 showing a chamfer defined in the cartridge body around the inner staple cavity, in accordance with various aspects of the present disclosure; FIG. 34 is an elevational cross-sectional view of a portion of the inner strut and cartridge body of the driver of FIG. 33 showing the inner strut in an unfired configuration relative to the inner staple cavity, in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a portion of a driver strut in accordance with various aspects of the present disclosure. FIG. 37 is an elevational view of a portion of the strut of FIG. 36 showing a portion of staples supported on the strut in accordance with various aspects of the present disclosure. FIG. 2 is an elevational view of a staple cartridge in accordance with various aspects of the present disclosure. 39 is an elevational cross-sectional view of the staple cartridge of FIG. 38 taken along the plane shown in FIG. 38, in accordance with various aspects of the present disclosure. FIG. 39 is a perspective cross-sectional view of a portion of the staple cartridge of FIG. 38 taken along the plane shown in FIG. 38 showing the driver in a fully fired position, in accordance with various aspects of the present disclosure; FIG. 41 is a perspective view of the driver of FIG. 40, in accordance with various aspects of the present disclosure. FIG. FIG. 2 is a perspective view of a driver in accordance with various aspects of the present disclosure. FIG. 3 is a perspective cross-sectional view of a portion of an anvil in accordance with various aspects of the present disclosure. FIG. 3 is a schematic diagram illustrating a process of deforming a 4D printed matrix for a staple cartridge in accordance with various aspects of the present disclosure. The staple cartridge further depicts the staple cartridge in a partially installed configuration aligned with the channel, showing an alignment and leverage mechanism for installing the staple cartridge in the channel, in accordance with various aspects of the present disclosure. and a perspective view of the channel. 46 is an elevational view of the proximal portion and channel of the staple cartridge of FIG. 45 showing the staple cartridge in an aligned and partially populated configuration in accordance with various aspects of the present disclosure; FIG. 46 is a perspective view of the distal portion and channel of the staple cartridge of FIG. 45 showing the staple cartridge in an aligned and partially populated configuration in accordance with various aspects of the present disclosure; FIG. 46 is a perspective view of the distal portion of the staple cartridge and channel of FIG. 45 showing the staple cartridge installed and fully seated within the channel and further illustrating the anvil in a clamp configuration with respect to the staple cartridge, according to various aspects of the present disclosure; FIG. It is. The distal portion of the staple cartridge of FIG. 48 showing the staple cartridge installed and fully seated within the channel and further showing a latch on the underside of the staple cartridge in a latched position relative to the channel, in accordance with various aspects of the present disclosure. , a channel, and an anvil. further illustrates a flexible latch on the underside of the staple cartridge in a latched position with respect to the channel, with the staple cartridge installed in the channel and the anvil in a clamped configuration with respect to the channel, according to various aspects of the present disclosure; FIG. 3 is a perspective view of a distal portion of the staple cartridge, channel, and anvil. The channel and lever are shown showing an alignment and levering mechanism for installing a staple cartridge in a channel, and further showing the staple cartridge in a partially installed configuration aligned with the channel, in accordance with various aspects of the present disclosure. FIG. 2 is a perspective view of a staple cartridge. FIG. 7 is a perspective view of a staple cartridge and a portion of a channel showing a lateral latch arm of the staple cartridge engaging a lateral passageway in a sidewall of the channel in accordance with various aspects of the present disclosure. 53 is a plan, partial cross-sectional view of a portion of the staple cartridge and channel of FIG. 52 showing a lateral latch arm of the staple cartridge engaging a lateral passageway in a sidewall of the channel, according to various aspects of the present disclosure; FIG. FIG. 2 is a perspective view of a staple cartridge and rotational drive screw in accordance with various aspects of the present disclosure. 55 is a perspective view of a distal portion of the staple cartridge and rotary drive screw of FIG. 54 showing the cartridge body and the driver with the driver in an unfired position within the cartridge body, according to various aspects of the present disclosure. FIG. 56 is a perspective view of the distal portion of the staple cartridge and rotary drive screw of FIG. 55 with the driver in an unfired position, showing internal mechanisms hidden in phantom for illustrative purposes, in accordance with various aspects of the present disclosure; FIG. 56 is another perspective view of the distal portion of the staple cartridge and rotary drive screw of FIG. 55 with the driver in an unfired position, showing internal mechanisms hidden in dashed lines for illustrative purposes, in accordance with various aspects of the present disclosure; FIG. . 55 is a perspective view of the distal portion of the staple cartridge of FIG. 54 with the driver moved to a firing position within the cartridge body, according to various aspects of the present disclosure. FIG. 59 is a perspective view of the distal portion of the staple cartridge of FIG. 58 with the driver in a firing position and showing internal mechanisms hidden in phantom for illustrative purposes, in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a proximal portion of a staple cartridge having a row of indentations in accordance with various aspects of the present disclosure. 61 is a perspective cross-sectional view of the staple cartridge of FIG. 60 showing a recess in the cartridge body that engages a lip in the side wall of the driver, in accordance with various aspects of the present disclosure; FIG. FIG. 4 is a perspective exploded view of a portion of a cartridge body and driver having an interference mechanism for engaging the cartridge body, in accordance with various aspects of the present disclosure. 1 is a perspective exploded view of a staple cartridge in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a cartridge frame and a portion of its arm in an unformed configuration, in accordance with various aspects of the present disclosure. 65 is a perspective view of a portion of the cartridge frame and arm of FIG. 64 showing the arm in a formed configuration, in accordance with various aspects of the present disclosure; FIG. FIG. 3 is an elevational cross-sectional view illustrating a heat swage retention mechanism between a cartridge body and a cartridge frame in accordance with various aspects of the present disclosure. FIG. 3 is an elevational cross-sectional view of a cartridge body and cartridge frame during a heat staking process, in accordance with various aspects of the present disclosure. 68 is a perspective view of a cartridge frame and insert support for use during the heat staking process of FIG. 67, according to various aspects of the present disclosure. FIG. 1 is a perspective view of a composite cartridge body including a metal pan and a plastic composite material, with the metal pan hidden in dashed lines for illustrative purposes, in accordance with various aspects of the present disclosure; FIG. 70 is an elevational view of the composite cartridge body of FIG. 69 showing a hidden metal pan with dashed lines for illustrative purposes, in accordance with various aspects of the present disclosure; FIG. 1 is a perspective view of a portion of a surgical end effector including a staple cartridge disposed therein, in accordance with various aspects of the present disclosure; FIG. 72 is an elevational cross-sectional view of a portion of the surgical end effector and staple cartridge of FIG. 71 in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a tamper-evident peel-off lid in accordance with various aspects of the present disclosure. FIG. 3 is a perspective view of a body of a sled assembly in accordance with various aspects of the present disclosure. 75 is a perspective exploded cross-sectional view of the sled assembly of FIG. 74 including a body and a knife in accordance with various aspects of the present disclosure; FIG. 75 is a perspective cross-sectional view of the sled assembly of FIG. 74 in accordance with various aspects of the present disclosure; FIG. 75 is an elevational partial cross-sectional view of the end effector, with portions removed for illustrative purposes, illustrating the firing member, cartridge body, and sled assembly of FIG. 74 in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a sled assembly aligned with a row of drivers in accordance with various aspects of the present disclosure. 79 is a perspective exploded view of the sled assembly of FIG. 78, in accordance with various aspects of the present disclosure; FIG. 79 is a perspective, partial cross-sectional view of the sled assembly of FIG. 78, in accordance with various aspects of the present disclosure; FIG. 79 is a perspective view of the sled assembly of FIG. 78 engaged with a firing system that includes a rotary drive screw and a firing member threadably coupled to the rotary drive screw, according to various aspects of the present disclosure. FIG. FIG. 3 is a perspective view of an end effector including a lockout in a locked configuration, in accordance with various aspects of the present disclosure. 83 is a perspective view of a portion of the end effector of FIG. 82 with parts removed for illustrative purposes, illustrating a lockout in a locking configuration, in accordance with various aspects of the present disclosure; FIG. 83 is an elevational cross-sectional view of a portion of the end effector of FIG. 82 illustrating lockout in a locking configuration, in accordance with various aspects of the present disclosure; FIG. 78 with parts removed for illustrative purposes, illustrating the staple cartridge including the sled assembly of FIG. 82 installed within an end effector and further illustrating lockout of the unlocked configuration, in accordance with various aspects of the present disclosure. FIG. 3 is a perspective view of a portion of the end effector. 86 is an elevational view of a portion of the staple cartridge and sled assembly of FIG. 85 showing the sled assembly in an unfired position, in accordance with various aspects of the present disclosure; FIG. 86 is a plan view of a portion of the underside of the staple cartridge and sled assembly of FIG. 85, showing the portion of the firing assembly with phantom lines for illustration purposes, in accordance with various aspects of the present disclosure; FIG. 86 is an elevational cross-sectional view of the staple cartridge of FIG. 85 in accordance with various aspects of the present disclosure. FIG. FIG. 3 is an elevational cross-sectional view of a staple cartridge in accordance with various aspects of the present disclosure. FIG. 3 is a perspective view of a firing member and sled assembly showing the firing member in an unfired configuration in accordance with various aspects of the present disclosure. 91 is an exploded view of the sled assembly of FIG. 90 in accordance with various aspects of the present disclosure; FIG. In accordance with various aspects of the present disclosure, shown in phantom for illustrative purposes, the firing member is moved into driving engagement with the sled assembly, and the firing member is moved into driving engagement with a driver within the cartridge body. 91 is a perspective view of the firing member and sled assembly of FIG. 90 relative to a cartridge body, showing the firing assembly in an advanced configuration in one embodiment; FIG. 91 is an elevational view of the firing member and sled assembly of FIG. 90, with certain hidden features shown in dashed lines for illustrative purposes, showing the firing member in a first advanced configuration, in accordance with various aspects of the present disclosure; FIG. 91 is an elevational cross-sectional view of the firing member and sled assembly of FIG. 90 taken along the plane shown in FIG. 90 showing the firing member in a first advanced configuration, in accordance with various aspects of the present disclosure; FIG. 94 is an elevational cross-sectional view of the firing member and sled assembly of FIG. 90 taken along the plane shown in FIG. 93, showing the firing member in a first advanced configuration, in accordance with various aspects of the present disclosure; FIG. 91 is an elevational view of the firing member and sled assembly of FIG. 90 with certain hidden features shown in dashed lines for illustrative purposes, showing the firing member in a first retracted configuration, in accordance with various aspects of the present disclosure; FIG. be. 91 is an elevational view of the firing member and sled assembly of FIG. 90 with certain hidden features shown in dashed lines for illustrative purposes, showing the firing member in a second retracted configuration, in accordance with various aspects of the present disclosure. be. 91 is an elevational view of the firing member and sled assembly of FIG. 90 with certain hidden features shown in dashed lines for illustrative purposes, showing the firing member in a third retracted configuration, in accordance with various aspects of the present disclosure. be. 91 is an elevational view of the firing member and sled assembly of FIG. 90 with certain hidden features shown in dashed lines for illustrative purposes, showing the firing member in a fourth retracted configuration, in accordance with various aspects of the present disclosure. be. The firing member of FIG. 90 is shown relative to the cartridge body of FIG. 92, with the firing member of FIG. 96D in a fourth retracted configuration, and the cartridge body is shown in phantom for illustrative purposes, in accordance with various aspects of the present disclosure. and an elevational view of the sled assembly. 96C is a top view of the firing member and sled assembly of FIG. 90 and the cartridge body of FIG. 92 showing the firing assembly of FIG. 96D in a fourth retracted configuration, in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a surgical end effector having a firing assembly that includes a rotary drive screw and a reusable firing member with an integral two-rail thread, in accordance with various aspects of the present disclosure. 100 is an exploded perspective view of the reusable firing member of FIG. 99 and a single-use knife and firing indicator for use with the reusable firing member, in accordance with various aspects of the present disclosure; FIG. FIG. 100A assembled to the reusable firing member of FIG. 99 further depicting a triple driver and staples disposed thereon by an integral two-rail thread of the reusable firing member in accordance with various aspects of the present disclosure. 1 is a perspective view of a single-use knife and firing indicator; FIG. 100B is an elevational view of the triple driver, staple, and reusable firing member of FIG. 100B, according to various aspects of the present disclosure. FIG. 100B is a perspective view of one of the triple drivers of FIG. 100B, in accordance with various aspects of the present disclosure. FIG. 100A is a plan view of a portion of the cartridge body that houses the triple driver of FIG. 100B and further illustrates the firing member of FIG. 100A, in accordance with various aspects of the present disclosure. FIG. 104 is a bottom perspective view of a portion of the cartridge body of FIG. 103 in accordance with various aspects of the present disclosure; FIG. FIG. 104 is an elevational cross-sectional view of an end effector including the cartridge body, firing member, and triple driver of FIG. 103 in accordance with various aspects of the present disclosure. 104 is a perspective cross-sectional view of the cartridge body of FIG. 103 in accordance with various aspects of the present disclosure; FIG. FIG. 3 is a perspective view of a cartridge body according to various aspects of the present disclosure. 99 is a perspective view of a portion of an end effector including a drive assembly of FIG. 99 showing a lockout configuration including a lockout nut mounted on a rotary drive screw with the lockout nut in a locked position, in accordance with various aspects of the present disclosure; FIG. be. 109 is an elevational view of the end effector of FIG. 108 with certain parts removed and other parts shown hidden in phantom, showing the lock nut in a locked position, in accordance with various aspects of the present disclosure; FIG. . The elevation of the end effector of FIG. 108 with certain parts removed and other parts hidden in phantom showing the lock nut in the unlocked position, in accordance with various aspects of the present disclosure. FIG. 104 is a perspective view of a portion of the cartridge body of FIG. 103 further illustrating a lockout key in a proximal position within the cartridge body, in accordance with various aspects of the present disclosure; FIG. In accordance with various aspects of the present disclosure, the cartridge body of FIG. 110 is installed in the end effector and the lockout key is disposed to overcome the lockout configuration by moving the lock nut to the unlocked position of FIG. 109B. 109 is a perspective view of a portion of the end effector of FIG. 108 in the position shown in FIG. 111 is a perspective view of a portion of the underside of the cartridge body of FIG. 110 showing the lockout key in an unfired position, in accordance with various aspects of the present disclosure; FIG. FIG. 110 , in which the cartridge body of FIG. 108 is installed within an end effector and partially cut away for illustrative purposes to advance and expose the lockout key to a distal position, in accordance with various aspects of the present disclosure. FIG. 2 is a partially cutaway perspective view of a portion of the end effector of FIG. 114 is a perspective view of a portion of the end effector and cartridge body of FIG. 113 with a lockout key in a distal position, in accordance with various aspects of the present disclosure; FIG. The illustration of the end effector of FIG. 110 with the cartridge body of FIG. 108 installed within the end effector and partially cut away for illustrative purposes to expose the lock nut in the locked position, in accordance with various aspects of the present disclosure. FIG. A perspective view of a portion of an end effector with certain portions removed and other portions transparent and shown in phantom for illustration purposes, illustrating a lockout configuration in a locking configuration, in accordance with various aspects of the present disclosure. It is a diagram. 117 is a perspective view of a portion of the end effector of FIG. 116 with certain portions removed and other portions transparent for illustration purposes, showing a lockout configuration in a locking configuration, in accordance with various aspects of the present disclosure; FIG. . FIG. 3 is a top view of a staple cartridge showing a pattern of staple cavities in accordance with various aspects of the present disclosure. FIG. 3 is a schematic diagram illustrating a staple cavity pattern of a staple cartridge in accordance with various aspects of the present disclosure. FIG. 3 is a schematic diagram illustrating a staple cavity pattern of a staple cartridge in accordance with various aspects of the present disclosure. FIG. 3 is a top view of a staple cartridge showing a pattern of staple cavities in accordance with various aspects of the present disclosure. 1 is a top view of a staple cartridge schematically illustrating a tissue stop in accordance with various aspects of the present disclosure; FIG.

Corresponding reference characters indicate corresponding parts throughout the figures. The examples set forth herein are illustrative of various embodiments of the invention in one form, and such illustrations should not be construed as limiting the scope of the invention in any way. do not have.

The applicant of this application owns the following United States patent applications filed on the same date as this application, each of which is incorporated herein by reference in its entirety.
- United States Patent Application entitled "METHOD OF USING A POWERED STAPLING DEVICE" with Attorney Docket No. END9298USNP1/200859-1M;
- United States Patent Application entitled "SURGICAL STAPLING ASSEMBLY COMPRISING NONPLANAR STAPLES AND PLANAR STAPLES" with Attorney Docket No. END9298USNP2/200859-2;
- United States patent application entitled ``SURGICAL STAPLE CARTRIDGE COMPRISING LONGITUDINAL SUPPORT BEAM'' with attorney docket number END9298USNP3/200859-3;
- United States patent application entitled "ROTARY-DRIVEN SURGICAL STAPLING ASSEMBLY COMPRISING ECCENTRICALLY DRIVEN FIRING MEMBER" with attorney docket number END9298USNP4/200859-4;
- United States patent application entitled "ROTARY-DRIVEN SURGICAL STAPLING ASSEMBLY COMPRISING A FLOATABLE COMPONENT" with Attorney Docket No. END9298USNP5/200859-5;
- United States patent application entitled ``DRIVERS FOR FASTENER CARTRIDGE ASSEMBLIES HAVING ROTARY DRIVE SCREWS'' with attorney docket number END9298USNP6/200859-6;
- United States patent application with attorney docket number END9298USNP7/200859-7 entitled "MATING FEATURES BETWEEN DRIVERS AND UNDERSIDE OF A CARTRIDGE DECK";
- United States patent application entitled "LEVERAGING SURFACES FOR CARTRIDGE INSTALLATION," attorney docket number END9298USNP8/200859-8;
- Agent docket number END9298USNP10/20085 entitled "FIRING MEMBERS HAVING FLEXIBLE PORTIONS FOR ADAPTING TO A LOAD DURING A SURGICAL FIRING STROKE" 9-10 US Patent Applications,
- United States patent application entitled "STAPLING ASSEMBLY COMPONENTS HAVING METAL SUBSTRATES AND PLASTIC BODIES," with attorney docket number END9298USNP11/200859-11;
- United States patent application entitled "MULTI-AXIS PIVOT JOINTS FOR SURGICAL INSTRUMENTS AND METHODS OF MANUFACTURING SAME" with attorney docket number END9298USNP12/200859-12;
- “JOINT ARRANGEMENTS FOR MULTI-PLANAR ALIGNMENT AND SUPPORT OF OPERATIONAL DRIVE SHAFTS IN ARTICULATABLE SURGICAL INSTRUMENT TS”, United States Patent Application No. END9298USNP13/200859-13, and
- Agent docket number END9298USNP14/2008 entitled “SURGICAL INSTRUMENT ARTICULATION JOINT ARRANGEMENTS COMPRISING MULTIPLE MOVING LINKAGE FEATURES” 59-14 US Patent Application.

The applicant of this application owns the following U.S. patent applications and patents filed on December 19, 2017, each of which is incorporated herein by reference in its entirety:
- U.S. Patent No. 10,835,330, entitled "METHOD FOR DETERMINING THE POSITION OF A ROTATABLE JAW OF A SURGICAL INSTRUMENT ATTACHMENT ASSEMBLY,"
- U.S. Patent No. 10,716,565, entitled "SURGICAL INSTRUMENTS WITH DUAL ARTICULATION DRIVERS";
- U.S. Pat. No. 83491),
- U.S. Patent No. 10,729,509, entitled "SURGICAL INSTRUMENT COMPRISING CLOSURE AND FIRING LOCKING MECHANISM";
- U.S. Pat.
- U.S. Design Patent No. D910,847, entitled "SURGICAL INSTRUMENT ASSEMBLY."

The applicant of this application owns the following U.S. patent applications and patents filed June 28, 2017, each of which is incorporated herein by reference in its entirety:
- U.S. Pat.
- U.S. Pat.
- U.S. Pat.
- U.S. Pat.
- U.S. Patent No. 15/635,837 (now U.S. Patent Application Publication No. 2019/0000472) entitled "SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE TO A FRAME";
- U.S. Patent No. 10,779,824, entitled "SURGICAL INSTRUMENT COMPRISING AN ARTICULATION SYSTEM LOCKABLE BY A CLOSURE SYSTEM";
- U.S. Pat.
- U.S. Pat.
- U.S. Pat.
- U.S. Pat.
- U.S. Patent No. 10,765,427, entitled "METHOD FOR ARTICULATING A SURGICAL INSTRUMENT";
- U.S. Patent No. 15/6 entitled "SURGICAL INSTRUMENTS WITH ARTICULATABLE END EFFECTOR WITH AXIALLY SHORTENED ARTICULATION JOINT CONFIGURATIONS" No. 35,530 (currently U.S. Patent Application Publication No. 2019/0000457);
- “SURGICAL INSTRUMENTS WITH OPEN AND CLOSABLE JAWS AND AXIAL MOVABLE FIRING MEMBER THAT IS INITIALY PARKED IN CLOSE PROX No. 10,588,633, entitled ``IMITY TO THE JAWS PRIOR TO FIRING'';
- “SURGICAL INSTRUMENTS WITH JAWS CONSTRAINED TO PIVOT ABOUT AN AXIS UPON CONTACT WITH A CLOSURE MEMBER THAT IS PARKED IN CL No. 15/635,559 entitled ``OSE PROXIMITY TO THE PIVOT AXIS'' No. 2019/0000459),
- U.S. Patent No. 10,786,253, entitled "SURGICAL END EFFECTORS WITH IMPROVED JAW APERTURE ARRANGEMENTS";
- “SURGICAL CUTTING AND FASTENING DEVICES WITH PIVOTABLE ANNVIL WITH A TISSUE LOCATION ARRANGEMENT IN CLOSE PROXIMITY TO AN A No. 15/635,594 (now U.S. Patent Application Publication No. 2019/0000461) entitled “NVIL PIVOT AXIS” ,
- “JAW RETAINER ARRANGEMENT FOR RETAINING A PIVOTABLE SURGICAL INSTRUMENT JAW IN PIVOTABLE RETAINING ENGAGEMENT WITH A SECON U.S. Patent No. 15/635,612 (now U.S. Patent Application Publication No. 2019/0000462) entitled “D SURGICAL INSTRUMENT JAW”;
- U.S. Patent No. 10,758,232 entitled "SURGICAL INSTRUMENT WITH POSITIVE JAW OPENING FEATURES";
- U.S. Patent No. 10,639,037, entitled "SURGICAL INSTRUMENT WITH AXIALLY MOVABLE CLOSURE MEMBER";
- U.S. Patent No. 10,695,057, entitled "SURGICAL INSTRUMENT LOCKOUT ARRANGEMENT";
- U.S. Design Patent No. D851,762, entitled "ANVIL";
- U.S. Design Patent No. D854,151, entitled "SURGICAL INSTRUMENT SHAFT," and
- U.S. Design Patent No. D869,655, entitled "SURGICAL FASTENER CARTRIDGE."

The applicant of this application owns the following U.S. patent applications and patents filed on June 27, 2017, each of which is incorporated herein by reference in its entirety:
- U.S. Patent No. 15/634,024 (now U.S. Patent Application Publication No. 2018/0368839) entitled "SURGICAL ANVIL MANUFACTURING METHODS";
- U.S. Patent No. 10,772,629, entitled "SURGICAL ANVIL ARRANGEMENTS";
- U.S. Patent No. 15/634,046 (now U.S. Patent Application Publication No. 2018/0368841) entitled "SURGICAL ANVIL ARRANGEMENTS";
- U.S. Patent No. 10,856,869, entitled "SURGICAL ANVIL ARRANGEMENTS";
- U.S. Patent No. 15/634,068 (now U.S. Patent Application Publication No. 2018/0368843) entitled "SURGICAL FIRING MEMBER ARRANGEMENTS";
- U.S. Patent No. 15/634,076 (now U.S. Patent Application Publication No. 2018/0368844) entitled "STAPLE FORMING POCKET ARRANGEMENTS";
- U.S. Patent No. 15/634,090 (now U.S. Patent Application Publication No. 2018/0368845) entitled "STAPLE FORMING POCKET ARRANGEMENTS"
- U.S. Pat. U.S. Patent No. ENTS No. 10,631,859.

The assignee of this application owns the following United States patent applications filed on June 2, 2020, each of which is incorporated herein by reference in its entirety.
- U.S. Design Patent Application No. 29/736,648, entitled "STAPLE CARTRIDGE";
- U.S. Design Patent Application No. 29/736,649, entitled "STAPLE CARTRIDGE";
- U.S. Design Patent Application No. 29/736,651, entitled "STAPLE CARTRIDGE";
- U.S. Design Patent Application No. 29/736,652, entitled "STAPLE CARTRIDGE";
- U.S. Design Patent Application No. 29/736,653, entitled "STAPLE CARTRIDGE";
- U.S. Design Patent Application No. 29/736,654 entitled "STAPLE CARTRIDGE," and
- U.S. Design Patent Application No. 29/736,655, entitled "STAPLE CARTRIDGE."

The applicant of this application owns the following U.S. design patent applications and U.S. patents filed on November 14, 2016, each of which is incorporated herein by reference in its entirety.
- U.S. Patent No. 15/350,621 (now U.S. Patent Application Publication No. 2018/0132849) entitled "STAPLE FORMING POCKET CONFIGURATIONS FOR CIRCULAR STAPLER ANVIL";
- U.S. Patent No. 15/350,624 (now U.S. Patent Application Publication No. 2018/0132854) entitled "CIRCULAR SURGICAL STAPLER WITH ANGULARLY ASYMMETRIC DECK FEATURES";
- United States Design Patent No. D833,608, entitled "STAPLING HEAD FEATURE FOR SURGICAL STAPLER," and - United States Design Patent No. D830,550, entitled "SURGICAL STAPLER."

As described in the specification and as illustrated in the accompanying drawings, numerous specific details are set forth to provide a thorough understanding of the overall structure, function, manufacture, and use of the embodiments. Well-known operations, components, and elements have not been described in detail so as not to obscure the embodiments described herein. The reader should understand that the embodiments described and illustrated herein are non-limiting examples and, therefore, that the specific structural and functional details disclosed herein are representative and exemplary. You will understand what you get. Variations and modifications may be made thereto without departing from the scope of the claims.

"comprise" (and any forms of comprise, such as "comprises" and "comprising"), "have" (and any forms of have, such as "has" and "having") ), "include" (and any forms of include, such as "includes" and "including"), and "contain" (and any forms of contain, such as "contains" and "containing"). The term (form of ) is an open-ended linking verb. As a result, a surgical system, device, or The device has one or more of these elements, but is not limited to having only one or more of these elements. Similarly, a system, device, or instrument that "comprises, has," "includes," or "contains" one or more features. An element has one or more of these characteristics, but is not limited to having only one or more of these characteristics.

The terms "proximal" and "distal" are used herein with reference to the clinician manipulating the handle portion of the surgical device. The term "proximal" refers to the part closest to the clinician, and the term "distal" refers to the part located away from the clinician. It will be further understood that for convenience and clarity, spatial terms such as "vertical," "horizontal," "above," and "below" may be used herein with respect to the drawings. However, surgical devices are used in many orientations and positions, and these terms are not intended to be limiting and/or absolute. In the following description, terms such as "first", "second", "upper", "lower", "upper", "lower", etc. are words of convenience and should not be construed as limiting terms. Shouldn't.

References to items in the singular should be understood to include items in the plural and vice versa, unless expressly stated otherwise or it is clear from the text. Grammatical conjunctions are intended to express any and all disjunctive and conjunctive combinations of joined clauses, sentences, words, etc., unless otherwise stated or clear from the context. Accordingly, the term "or" should generally be understood to mean "and/or" and the like.

The description of ranges of values in the present invention is intended to refer to each and every value included within that range individually, and not as a limitation, unless otherwise stated herein. , each separate value within such range is incorporated herein as if individually recited herein. Words such as "about", "approximately", etc., when accompanied by numerical values, are used to indicate deviations, as understood by those skilled in the art, from satisfactory performance for the intended purpose. should be interpreted. Similarly, words of approximation such as "approximately" or "substantially" when used in reference to a physical property are used as recognized by those skilled in the art to operate satisfactorily for the corresponding use, function, purpose, etc. should be interpreted to give an idea of the range of deviations that may occur.

Any and all examples provided herein, the use of exemplary language (such as "for example," "etc." or otherwise) are merely intended to better elucidate each embodiment. , does not impose any limitations on the scope of the embodiments. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the embodiments.

Various exemplary devices and methods are provided for performing laparoscopic and minimally invasive surgical procedures. However, the reader will readily appreciate that the various methods and devices disclosed herein can be used in many surgical procedures and applications, including, for example, those associated with open surgical procedures. . As the detailed description of the invention proceeds, the reader will appreciate that the various surgical devices disclosed herein may be introduced into the body in any manner, such as through a natural orifice, through an incision or puncture hole formed in tissue, etc. It will be further understood that it may be inserted. The working or end effector portion of the surgical device may be inserted directly into the patient's body or through an access device having a working channel through which the end effector and elongate shaft of the surgical device can be advanced.

The surgical stapling system can include a shaft and an end effector extending from the shaft. The end effector includes a first jaw and a second jaw. The first jaw includes a staple cartridge. The staple cartridge is insertable into and removable from the first jaw, but the staple cartridge is not removable or at least easily replaceable from the first jaw. Other embodiments are envisioned. The second jaw includes an anvil configured to deform staples ejected from the staple cartridge. The second jaw is pivotable relative to the first jaw about the closure axis, although other embodiments are envisioned in which the first jaw is pivotable relative to the second jaw. Ru. The surgical stapling system further includes an articulation joint configured to allow the end effector to rotate or articulate relative to the shaft. The end effector is rotatable about an articulation axis extending through the articulation joint. Other embodiments that do not include articulation joints are also envisioned.

The staple cartridge includes a cartridge body. The cartridge body includes a proximal end, a distal end, and a deck extending between the proximal and distal ends. In use, the staple cartridge is placed on a first side of the tissue to be stapled and the anvil is placed on a second side of the tissue. The anvil is moved toward the staple cartridge to force and clamp the tissue against the deck. Staples removably stored within the cartridge body can then be deployed into tissue. The cartridge body includes a staple cavity defined therein, and the staples are removably stored within the staple cavity. The staple cavities are arranged in six longitudinal rows. Three rows of staple cavities are positioned on a first side of the longitudinal slot and three rows of staple cavities are positioned on a second side of the longitudinal slot. Other arrangements of staple cavities and staples are also envisioned.

The staples are supported by a staple driver within the cartridge body. The driver is movable between a first or unfired position and a second or fired position for ejecting staples from the staple cavity. The driver is retained within the cartridge body by a retainer that extends around a lower portion of the cartridge body and includes a resilient member configured to grip the cartridge body and hold the retainer relative to the cartridge body. The drivers are movable by the sled between their unfired position and their fired position. The sled is movable between a proximal position adjacent the proximal end of the cartridge body and a distal position adjacent the distal end of the cartridge body. The sled includes a plurality of ramps configured to slide under the driver and lift the driver onto which the staples are supported toward the anvil.

In addition to the above, the sled is moved distally by the firing member. The firing member is configured to contact the sled and push the sled toward the distal end. A longitudinal slot defined within the cartridge body is configured to receive a firing member. The anvil also includes a slot configured to receive a firing member. The firing member further includes a first cam that engages the first jaw and a second cam that engages the second jaw. Upon distally advancing the firing member, the first cam and the second cam can control the distance, or tissue gap, between the deck of the staple cartridge and the anvil. The firing member also includes a knife configured to ablate tissue captured intermediate the staple cartridge and the anvil. Desirably, the knife is positioned at least partially proximal to the ramp so that the staples are ejected into the tissue in front of the knife that resects the tissue.

1-8 illustrate a surgical stapling instrument 10 configured to clamp, staple, and cut tissue of a patient. Surgical stapling instrument 10 includes a handle 20, a shaft assembly 100 attached to handle 20, and an end effector 200. For cutting and stapling patient tissue, end effector 200 includes cartridge jaws 201 and anvil jaws 203. Anvil jaw 203 is pivotable relative to cartridge jaw 203 to clamp tissue between anvil jaw 203 and cartridge jaw 203. Once the tissue is clamped between the jaws 201, 203, the surgical stapling instrument 10 connects the jaws 201 to staple and cut the tissue using the end effector 200, as discussed in more detail below. , 203 to advance the firing member through the firing member.

As discussed in more detail below, end effector 200 is articulatable by articulation region 110 of shaft assembly 100. Such articulation provides the user of surgical stapling instrument 10 with the ability to more accurately position and/or manipulate end effector 200 near target tissue.

Handle 20 includes a housing 21 configured to house various mechanical and electrical components and a handle portion 22 extending from housing 21. Handle portion 22 is configured to fit in the palm of a user's hand and/or is configured to be grasped and/or held by a user using surgical stapling instrument 10. Handle 20 further includes various actuators and/or triggers configured to be actuated by a user to operate one or more functions of surgical stapling instrument 10. Handle 20 includes a closure trigger 24, a firing trigger 25, and at least one articulation actuator 26. When actuated by a user, closure trigger 24 is configured to clamp tissue with end effector 200 by moving anvil jaw 203 toward cartridge jaw 201. Firing trigger 25, when actuated by a user, is configured to advance the firing member to eject the staples and cut and staple tissue with end effector 200 by cutting the tissue with the knife. When actuated by a user, articulation actuator 26 is configured to articulate end effector 200 relative to shaft assembly 100 through articulation region 110. The triggers and actuators of surgical stapling instrument 10 may trigger one or more motors within handle 20 to actuate various functions of surgical stapling instrument 10 and/or actuate various drive shafts. and components can be manually actuated to operate various functions of surgical stapling instrument 10.

Handle 20 further includes a nozzle assembly 30 configured to support shaft assembly 100 therein. Nozzle assembly 30 includes an actuation wheel 31 configured to be rotated by a user to rotate shaft assembly 100 and end effector 200 relative to handle 20 about longitudinal axis LA. Such a mechanism allows a user of surgical stapling instrument 10 to rotate only shaft assembly 100 and/or end effector 200 without having to rotate entire handle 20.

Handle 20 further includes a battery 23 configured to power various electronic components, sensors, and/or motors of surgical stapling instrument 10. Embodiments are envisioned in which surgical stapling instrument 10 is connected directly to a power source. Embodiments are also envisioned in which surgical stapling instrument 10 is, for example, fully manual or non-powered. Embodiments are further envisioned in which articulation of the end effector, clamping and unclamping of the jaws, firing of the end effector staple and cut tissue, and rotation of the shaft and/or end effector are all electrically powered systems.

In at least one case, shaft assembly 100 and end effector 200 may be modular and removable from handle 20. In at least one case, end effector 200 may be modular in that end effector 200 can be removed from shaft assembly 100 and replaced with a different end effector. In at least one case, shaft assembly 100 and/or end effector 200 are usable in a surgical robotic environment. Such embodiments provide power input from the surgical robotic interface to actuate each function of end effector 200. Examples of such surgical robots and surgical tools are further described in U.S. Patent Application Publication No. 2020/0138534, entitled "ROBOTIC SURGICAL SYSTEM," published May 7, 2020, which Incorporated herein by reference in its entirety.

In at least one case, shaft assembly 100 and end effector 200 are configured for use with a surgical robot. In such a case, shaft assembly 100 and end effector 200 are configured to be coupled to a surgical robot that includes multiple output drivers. The plurality of output drivers of the surgical robot are configured to mate with the drive system of shaft assembly 100 and end effector 200. In such cases, the surgical robot may actuate a variety of different functions of the end effector 200, such as articulating the end effector about multiple different articulation joints, the shaft assembly 100, and/or rotating end effector 200 about its longitudinal axis; clamping end effector 200 to clamp tissue between the jaws of end effector 200; and/or firing end effector 200 to cut and cut tissue. /or can be stapled.

Shaft assembly 100 is configured to house various drive system components and/or electronics of surgical stapling instrument 10 such that end effector 200 and shaft assembly 100 may be inserted through a trocar for laparoscopic surgery. configured. Various drive system components are configured to be actuated by various triggers and actuators on handle 20. Such components may include a drive shaft for articulation, a drive shaft for clamping and unclamping the end effector 200, and/or a drive shaft for firing the end effector 200. Such a drive shaft may be rotated by a drive system within handle 20 or a surgical robotic interface when shaft assembly 100 is connected to handle 20. In various embodiments, the stapling end effector can include two independently rotatable drive members, e.g., one for grasping tissue and one for firing staples. belongs to. The stapling end effector can further include an articulation joint, and rotational movement can be transmitted through the articulation joint. In various aspects, the stapling end effector can include one or more 3D printed assemblies that can be incorporated into an articulation system, grasping system, or firing system.

Such a drive shaft may be actuated by a drive system within handle 20 or a surgical robotic interface if shaft assembly 100 is connected to handle 20. Such drive shafts may have linear actuation, rotary actuation, or a combination thereof. A combination of rotary and linear actuation may, for example, use a series of rack gears and/or drive screws.

In at least one case, shaft assembly 100 is also configured to accommodate, e.g., electrical leads for various sensors and/or motors disposed within shaft assembly 100 and/or end effector 200. There is.

Shaft assembly 100 includes an outer shaft 101 that extends from nozzle assembly 30 to an articulation region 110 that includes a dual articulation joint that will be described in more detail below. Articulation region 110 allows end effector 200 to articulate relative to outer shaft 101 in two different planes about two separate axes AA1, AA2.

Referring now primarily to FIG. 4, the articulation of end effector 200 will now be described. Articulation area 110 includes two different articulation joints and two articulation actuators 150, 160. This allows the end effector 200 to be articulated in two different planes around two different axes AA1, AA2, independently of each other. Articulation region 110 includes proximal joint shaft component 120, intermediate joint shaft component 130, and distal joint shaft component 140. A proximal joint shaft component 120 is attached to the distal end of the shaft assembly 100, and an intermediate joint shaft component 130 is pivotally connected to the proximal joint shaft component 120 and the distal joint shaft component 140. The distal joint shaft component 140 is fixedly attached to the end effector 200 by a retaining ring 146. As discussed in more detail below, this configuration provides articulation of end effector 200 relative to shaft assembly 100 about axis AA1 and axis AA2 independently of each other.

Proximal joint shaft component 120 includes a proximal annular portion 121 fixedly fitted within outer shaft 101 . Proximal joint shaft component 120 also includes a hollow passageway 122 to allow passage of various drive system components therethrough, and includes a pin hole 124 configured to receive an articulation pin 125. Further includes articulation tabs 123. Articulation pin 125 pivotally connects proximal joint shaft component 120 to proximal articulation tab 131 of intermediate joint shaft component 130. To articulate end effector 200 about axis AA1, articulation actuator 150 is actuated linearly in either a distal or proximal direction. Such an actuator may for example comprise a bar or rod made of any suitable material such as metal and/or plastic. Articulation actuator 150 is pivotally mounted to articulation crosslink 151 . Articulation crosslink 151 is pivotally mounted to intermediate joint shaft component 130 off-axis relative to articulation pin 125 such that when articulation actuator 150 is actuated, articulation crosslink 151 A torque is applied to the intermediate joint shaft component 130 off-axis relative to the articulation pin 125 to cause the intermediate joint shaft component 130, and thus the end effector 200, to rotate relative to the proximal joint shaft component 120 about axis AA1. Pivot.

Intermediate joint shaft component 130 is pivotally connected to proximal joint shaft component 120 by articulation pin 125 that defines axis AA1. Specifically, intermediate joint shaft component 130 includes a proximal articulation tab 131 pivotally connected to proximal joint shaft component 120 by articulation pin 125. Intermediate joint shaft component 130 further includes a hollow passageway 132 configured to allow passage of various drive system components therethrough, and a distal articulation tab 133. Distal articulation tab 133 includes a pin hole 134 configured to receive another articulation pin 136 defining axis AA2 and a distally projecting key 135.

To articulate end effector 200 about axis AA2, articulation cable 160 is actuated by key 135 to apply an articulation torque to proximal tab 141 of distal joint shaft component 140. Articulation cable 160 is secured to key 135 such that when cable 160 is rotated, key 135 pivots relative to intermediate joint shaft component 130. Key 135 fits within keyhole 144 of distal joint shaft component 140. Note that the key 135 is not fixed to the intermediate joint shaft component 130, and the key 135 is rotatable with respect to the intermediate joint shaft component 130. Articulation cable 160 also contacts proximal tab 141 around pin hole 142. This provides an additional torque moment from articulation cable 160 to distal joint shaft component 140. Articulation pin 136 is received within pin hole 142 to pivotally connect intermediate joint shaft component 130 and distal joint shaft component 140.

In at least one case, articulation cable 160 can only be pulled in a proximal direction. In such cases, only one side of articulation cable 160 is pulled proximally to articulate end effector 200 in the desired direction. In at least one case, articulation cables 160 are pushed and pulled in a competitive manner. In other words, cable 160 can include a rigid structure such that one side of articulation cable 160 is pushed distally and the other side of articulation cable 160 is pulled proximally. Such a configuration may allow articulation forces to be split between the pushed half of cable 160 and the pulled half of cable 160. In at least one case, the push-pull configuration allows greater articulation forces to be transferred to the corresponding articulation joint. Such forces may be necessary in configurations with two articulating joints. For example, if the proximal articulation joint is fully articulated, the distal articulation joint must be moved due to the extension and/or extension distance that the articulation actuator for the distal articulation joint must travel. More force may be required by the articulation actuator to articulate.

Distal joint shaft component 140 further includes a notch 143 that allows various drive components to pass therethrough. Retaining ring 146 secures channel 210 of cartridge jaw 201 to distal joint shaft component 140, thereby securing end effector assembly 200 to the distal end of articulation region 110.

As mentioned above, anvil jaw 201 is movable relative to cartridge jaw 203 to clamp and unclamp tissue at end effector 200. Next, the operation of this function of end effector 200 will be described. Cartridge jaw 201 includes a channel 210 and a staple cartridge 220 configured to be received within a cavity 214 of channel 210. Channel 210 further includes an annular groove 211 configured to receive retaining ring 146 and a pair of pivot holes 213 configured to receive jaw coupling pins 233. Jaw coupling pin 233 allows anvil jaw 203 to pivot relative to cartridge jaw 201.

Anvil jaw 203 includes an anvil body 230 and a pair of pivot holes 231 . A pivot hole 231 in the proximal portion of anvil jaw 203 is configured to receive a jaw coupling pin 233, thereby pivotally coupling anvil jaw 203 to cartridge jaw 201. A closure driver 250 is provided to open and close anvil jaw 203 relative to cartridge jaw 201.

The closure driver 250 is actuated by a flexible drive segment 175 consisting of a universal joint arranged or formed end-to-end. In various cases, flexible drive segments 175 can include serial 3D printed universal fittings that are all printed together as a single continuous system. As described in more detail below, flexible drive segment 175 is driven by an input shaft that traverses shaft assembly 100. Flexible drive segment 175 transmits rotary actuation motion via a double articulation joint. The closure driver 250 includes a closure screw 251 and a closure wedge 255 threadably coupled to the closure screw 251. Closing wedge 255 is configured to positively cam open and close anvil jaw 203. The closure screw 251 is supported by a first support 258 and a second support 259 fixed within the channel 210.

To move anvil jaw 203 between a clamped position (FIG. 8) and an unclamped position (FIG. 7), the closing drive shaft is actuated to actuate flexible drive segment 175. Flexible drive segment 175 is configured to rotate closure screw 251 displacing closure wedge 255. For example, closure wedge 255 is threadably coupled to closure screw 251 to inhibit rotational movement of closure wedge 255 with staple cartridge 220 . Closure screw 251 drives closure wedge 255 proximally or distally depending on the direction in which closure screw 251 is rotated.

Closure wedge 255 is moved proximally to clamp end effector 200 from the unclamped position (FIG. 7). As closure wedge 255 moves proximally, proximal cam surface 256 of closure wedge 255 contacts a corresponding cam surface 234 defined on proximal end 235 of anvil body 230. When camming surface 256 contacts camming surface 234, a force is applied to proximal end 235 of anvil body 230, rotating anvil body 230 about pin 233 to the clamped position (FIG. 8).

To open or unclamp the end effector 200 from the clamped position (FIG. 8), the closure wedge 255 is moved distally by rotating the closure screw 251 in the opposite direction to move the closure wedge 255 proximally. will be moved to As closure wedge 255 is moved distally, a pair of nubs 257 extending from the distal end of closure wedge 255 contact camming surface 234 near downwardly extending tabs 237 of anvil body 230. When nub 257 contacts camming surface 234 near tab 237, a force is applied to anvil body 230 causing it to rotate about pin 233 to the open position (FIG. 7).

In at least one case, the contour of cam surface 234 corresponds to the contour of cam surface 256. For example, camming surface 234 and camming surface 256 may coincide such that a maximum camming force is applied to anvil body 230 to cause the desired rotation of anvil body 230. As seen in FIG. 8, for example, camming surface 234 defined by proximal end 235 of anvil body 230 includes an angled section similar to the angled section of the upper angled section of camming surface 256.

As discussed above, surgical stapling instrument 10 may be actuated to advance a firing member through jaws 201 , 203 to staple and cut tissue using end effector 200 . Next, the function of deploying staples 226 from staple cartridge 220 and cutting tissue with knife 283 will be described. The staple cartridge 220 includes a cartridge body 221, a plurality of staple drivers 225, and a plurality of staples 226 removably housed within the cartridge body 221. Cartridge body 221 includes a deck surface 222 , a plurality of staple cavities 223 arranged in longitudinal rows defined within cartridge body 221 , and longitudinal slots 224 bifurcating cartridge body 221 . Knife 283 is configured to be driven through longitudinal slot 224 to cut tissue clamped between anvil body 230 and deck surface 221.

Deck surface 221 includes a laterally contoured tissue support surface. In various embodiments, the profile of the deck surface 221 can form a peak along the central portion of the cartridge body 221. Such a peak may cover a longitudinally extending firing screw 261 that extends through the central portion of the cartridge body 221, as further described herein. The increased height along the peak may be associated with smaller tissue gaps along the firing path of knife 283 in various cases. In certain aspects of the present disclosure, the driver height, formed staple height, staple pocket extension height, and/or staple overdrive distance may also vary laterally along the deck surface 221. Laterally variable staple formations (eg, a combination of 2D staples and 3D staples) are also contemplated and described further herein.

Staple driver 225 is configured to be lifted by sled 280 and eject staples 226 supported by staple driver 225 into staple cavity 223 when sled 280 is pushed distally through staple cartridge 220. . Sled 280 includes a ramp 281 for contacting staple driver 225. Sled 280 also includes a knife 283. Sled 280 is configured to be pushed by firing member 270.

End effector 200 includes firing driver 260 for deploying staples 226 and cutting tissue with knife 283. Firing driver 260 is actuated by flexible drive shaft 176. As described in more detail below, flexible drive shaft 176 is driven by an input shaft that traverses shaft assembly 100. A flexible drive shaft 176 transmits rotational actuation motion through a double articulation joint. Firing driver 260 includes a firing screw 261 configured to be rotated by flexible drive shaft 176. Firing screw 261 includes a support member 259 and a journal supported in a bearing within channel 210 . In various cases, firing screw 261 may float relative to channel 210, as further described herein. Firing screw 261 extends along a portion of the length of firing screw 261, with a proximal end 262 supported within support member 259 and channel 210, and a distal end 263 supported within channel 210. A screw thread 265 is provided.

Firing member 270 is threadably coupled to firing screw 261 such that firing member 270 advances distally or retracts proximally along firing screw 261 as firing screw 261 rotates. There is. Specifically, firing member 270 includes a body portion 271 with a hollow passageway 272 defined therein. Firing screw 261 is configured to be received within hollow passageway 272 and is configured to be threadedly coupled with threaded component 273 of firing member 270 . Thus, when firing screw 261 is rotated, threaded component 273 applies a linear force to body portion 271 to either advance firing member 270 distally or retract firing member 270 proximally. . As firing member 270 is advanced distally, firing member 270 pushes against sled 280 . Distal movement of sled 280 causes ejection of staples 223 by engaging multiple staple drivers 225, as further described herein. Driver 225 is a triple driver configured to fire multiple staples 223 simultaneously. Driver 225 includes lateral asymmetry in various cases to maximize thread rail width and accommodate firing screw 261 below the center of cartridge 220, as further described herein. obtain.

At some point during firing of end effector 200, the user may retract firing member 270 to allow unclamping of jaws 201, 203. In at least one case, full retraction of the firing member 270 is required to open the jaws 201, 203, in which case the firing member 270 can only be disengaged from the jaws 201, 203 once fully retracted. Upper and lower cam members are provided on the body portion 271.

In various cases, firing member 270 may be a hybrid construction of plastic and metal portions, as further described herein. In various cases, threaded component 273 can be a metal component that is incorporated into firing member body 271 by, for example, insert molding or overmolding.

Firing member 270 may also be referred to as an I-beam in certain cases. Firing member 270 may include a complex 3D printed shape that includes a grid pattern of spaces therein. In various cases, 3D printing allows the firing member or part thereof to act as a spring, allowing the part to bend more easily, thereby improving, for example, the distribution of forces during the firing stroke and /or Tolerances can be improved.

9-11 illustrate a surgical stapling assembly 300 that includes a shaft assembly 310 and the end effector 200 of FIGS. 1-8 attached to the shaft assembly 310. FIGS. Shaft assembly 310 may be similar in many respects to various other shaft assemblies described herein, however, shaft assembly 310 may include a single articulation joint and end effector 200 in a single articulation joint. and an articulation bar configured to articulate about the motion joint. Surgical stapling assembly 300 is configured to cut and staple tissue. Surgical stapling assembly 300 may be attached to a surgical instrument handle and/or a surgical robot interface. The surgical instrument handle and/or the surgical robot interface may be configured to actuate various functions of the surgical stapling assembly 300. Shaft assembly 310 includes an articulation joint 320. As discussed in more detail below, end effector 200 is configured to be articulated about axis AA with respect to outer shaft 311 of shaft assembly 310.

The shaft assembly 310 includes an outer shaft 311 , a first shaft joint component 330 , and a second shaft joint component 350 pivotally coupled to the first shaft joint component 330 by an articulation pin 354 . Equipped with. First shaft coupling component 330 includes a proximal tube portion 331 configured to fit within the inner diameter of outer shaft 311 . Such a fit may include, for example, a press fit. However, any suitable attachment means may be used. First shaft coupling component 330 also includes a distal portion 332. Distal portion 332 includes an articulation tab 333 with a pin hole 334 defined therein and a hollow passageway 335 through which various drive components of surgical stapling assembly 300 can pass. Such drive components may include, for example, articulation actuators, closure actuators, and/or firing actuators.

First shaft joint component 330 is pivotally connected to second shaft joint component 350 by articulation pin 354 . Articulation pin 354 is also received within pin hole 353 of proximally extending articulation tab 351 of second shaft joint component 350 . Pin hole 353 is aligned with pin hole 334 in the axial direction. Articulation pin 354 allows second shaft joint component 350 to be articulated relative to first shaft joint component 330 about articulation axis AA. Second shaft joint component 350 further includes a pin protrusion 352 extending from proximally extending articulation tab 351 . As discussed in more detail below, pin protrusion 352 is configured to be pivotally coupled to an articulation drive system. Second shaft coupling component 350 further includes a distal portion 355 with an annular groove 356 configured to receive a retaining ring 358. Distal portion 355 also includes a hollow passageway 357 through which various drive components of surgical stapling assembly 300 can pass. Retaining ring 358 retains first jaw 201 to second shaft coupling component 350 by fitting within annular groove 211 of cartridge channel 210 and annular groove 356 of second shaft coupling component 350 It is configured as follows.

An articulation bar 360 is provided to articulate end effector 200 about articulation axis AA. Articulation bar 360 may be actuated by any suitable means, such as, for example, a robot or a motorized input and/or a manual handle trigger. Articulation bar 360 may be actuated, for example, in proximal and distal directions. Embodiments are envisioned in which the articulation system comprises rotational drive actuation in addition to or instead of linear actuation. Articulation bar 360 extends through outer shaft 311. Articulation bar 360 includes a distal end 361 pivotally connected to articulation link 362 . Articulation connection 362 is pivotally connected from proximal extending articulation tab 351 to a pin protrusion 352 extending from the central articulation tab relative to articulation axis AA. Such eccentric coupling of articulation connection 362 allows articulation bar 360 to apply a force to second shaft joint component 350 to cause second shaft joint component 350, and thus end effector 200, to move toward the first shaft joint component 350. Allowing for rotation relative to shaft coupling component 330. Articulation bar 360 is advanced distally to rotate end effector 200 in a first direction about articulation axis AA and retracted proximally to rotate end effector 200 in a first direction about articulation axis AA. can be rotated in a second direction opposite to the direction of.

Shaft assembly 310 further includes an articulation component support structure 340 disposed within articulation joint 320. Such support structure can provide support to various drive components configured to pass through articulation joint 320 to end effector 200 when end effector 200 is articulated. Support structure 340 may also serve to isolate the drive components from tissue debris during use.

12-14 illustrate a surgical stapling assembly 400 that includes a shaft assembly 410 and the end effector 200 of FIGS. 1-8 attached to the shaft assembly 410. Shaft assembly 410 may be similar in many respects to various other shaft assemblies described herein, however, shaft assembly 410 may include a single articulation joint and end effector 200 in a single articulation joint. and an articulation cable configured to articulate about the motion joint. Surgical stapling assembly 400 is configured to cut and staple tissue. Surgical stapling assembly 400 may be attached to a surgical instrument handle and/or a surgical robot interface. The surgical instrument handle and/or the surgical robot interface may be configured to actuate various functions of the surgical stapling assembly 400. Shaft assembly 410 includes an articulation joint 420. As discussed in more detail below, end effector 200 is configured to articulate relative to outer shaft 411 of shaft assembly 310 about axis AA.

Shaft assembly 410 includes an outer shaft 411 , a first shaft joint component 430 , and a second shaft joint component 450 pivotally coupled to first shaft joint component 430 by articulation pin 454 . Equipped with. First shaft coupling component 430 includes a proximal tube portion 431 configured to fit within the inner diameter of outer shaft 411 . Such a fit may include, for example, a press fit. However, any suitable attachment means may be used. The first shaft joint component 430 also includes a distal portion 432 that includes an articulation tab 433 with a pin hole 434 defined therein. Distal portion 432 further defines a hollow passageway 435 through which various drive components of surgical stapling assembly 400 may pass. Such drive components may include, for example, articulation actuators, closure actuators, and/or firing actuators.

First shaft joint component 430 is pivotally connected to second shaft joint component 450 by articulation pin 454 . Articulation pin 454 is also received within pin hole 453 of proximally extending articulation tab 451 of second shaft joint component 450 . Articulation pin 454 allows second shaft joint component 450 to be articulated relative to first shaft joint component 430 about articulation axis AA. Second shaft coupling component 450 further includes a drive ring structure 452. Drive ring structure 452 extends from proximally extending articulation tab 451 and further defines a portion of pin hole 453. As discussed in more detail below, drive ring structure 452 is configured to be engaged by an articulation drive system. Second shaft coupling component 450 further includes a distal portion 455 with an annular groove 456 configured to receive a retaining ring 458. A hollow passageway 457 through distal portion 455 is configured to receive various drive components of surgical stapling assembly 400 therethrough. Retaining ring 458 retains first jaw 201 to second shaft coupling component 450 by fitting within annular groove 211 of cartridge channel 210 and annular groove 456 of second shaft coupling component 450 It is configured as follows.

An articulation cable 460 is provided for articulating end effector 200 about articulation axis AA. Articulation cable 460 may be actuated by any suitable means, such as, for example, a robotic input on the handle of a hand-held surgical instrument and/or a manual trigger. Articulation cable 460 may include an antagonistic actuation profile. In other words, when the first side of articulation cable 460 is pulled proximally, the second side of articulation cable 460 is allowed to advance distally like a pulley system. Similarly, when the second side is pulled proximally, the first side can be advanced distally. Articulation cable 460 extends through outer shaft 411. An articulation cable 460 is disposed about and frictionally retained on the drive ring structure 452 to allow rotation of the second shaft joint component 450 when the articulation cable 460 is actuated. When articulation cable 460 is actuated, articulation cable 460 is configured to apply a rotational torque to drive ring structure 452 of second shaft joint component 450 and thus end effector 200 . Such torque is configured to rotate or pivot second shaft joint component 450 relative to first shaft joint component 430, thereby articulating end effector 200 relative to outer shaft 411. be done. A first side of articulation cable 460 is capable of pulling end effector 200 to rotate about articulation axis AA in a first direction, and a second side of articulation cable 460 is capable of pulling end effector 200 to rotate about articulation axis AA in a first direction. can be pulled to rotate about the articulation axis AA in a second direction opposite to the first direction.

Shaft assembly 410 further includes an articulation component support structure 440 disposed within articulation joint 420. Such support structure 440 can provide support to various drive components configured to pass through articulation joint 420 to end effector 200 when end effector 200 is articulated. . Support structure 440 may also serve to isolate the drive components from tissue debris during use.

Surgical stapling assembly 400 further includes a closure drive shaft segment 475 and a firing drive shaft segment 476, each configured to transmit rotational motion to end effector 200 through articulation joint 420. Drive shaft segments 475, 476 are configured to passively expand and contract longitudinally as end effector 200 is articulated. For example, articulation causes expansion and contraction of drive shaft segments 475, 476 to account for respective longitudinal extension or contraction of the length of the drive shaft due to articulation of end effector 200 with respect to shaft assembly 410. be able to. During expansion and contraction of the drive shaft segments 475 , 476 , the drive shaft segments 475 , 476 maintain rotational driving engagement with the corresponding input shaft extending through the outer shaft 411 and the output shaft within the end effector 200 . In at least one case, the output shaft includes a closure screw 251 configured to effect grasping, closure, or tissue manipulation by the jaws 201 , 203 and a clamping of the jaws 201 , 203 and firing of the firing member 270 . and a configured firing screw 261.

15-17 illustrate a surgical stapling assembly 500 that includes a shaft assembly 510 and the end effector 200 of FIGS. 1-8 attached to the shaft assembly 510. Shaft assembly 510 may be similar in many respects to various other shaft assemblies described herein, however, shaft assembly 510 includes a single joint configured to passively expand and contract. It includes a kinematic joint and a drive shaft segment. Surgical stapling assembly 500 is configured to cut and staple tissue. Surgical stapling assembly 500 may be attached to a surgical instrument handle and/or a surgical robot interface. The surgical instrument handle and/or the surgical robot interface may be configured to actuate various functions of the surgical stapling assembly 500. Shaft assembly 510 includes an articulation joint 520. As discussed in more detail below, end effector 200 is configured to be articulated about axis AA.

Shaft assembly 510 includes a first shaft joint component 530 and a second shaft joint component 540 pivotally coupled to first shaft joint component 530 by an articulation pin 543. First shaft coupling component 530 is configured to attach to a shaft of a surgical instrument assembly and/or surgical robotic interface. First shaft joint component 530 includes a proximal portion 531 and an articulation tab 533 with a pin hole 534 defined therein. In at least one case, first shaft coupling component 530 includes a hollow passageway through which various drive components of surgical stapling assembly 400 can pass. Such drive components may include, for example, articulation actuators, closure actuators, and/or firing actuators.

First shaft joint component 530 is pivotally connected to second shaft joint component 540 by articulation pin 543. Articulation pin 543 is also received within pin hole 542 of proximally extending articulation tab 541 of second shaft joint component 540 . Articulation pin 543 allows second shaft joint component 540 to be articulated relative to first shaft joint component 530 about articulation axis AA. Second shaft coupling component 540 includes an annular groove 547 configured to receive a retaining ring 548 and a hollow passageway 546 through which various drive components of surgical stapling assembly 500 can pass. A distal portion 545 is further included. Retaining ring 548 retains first jaw 201 to second shaft coupling component 540 by fitting within annular groove 211 of cartridge channel 210 and annular groove 547 of second shaft coupling component 540 It is configured as follows.

Any suitable articulation drive system may be used to articulate end effector 200 about axis AA. In at least one case, end effector 200 is passively articulated. In such instances, end effector 200 may be pressed against tissue, for example, to apply a force to end effector 200 to cause it to articulate about an articulation axis. In at least one case, the end effector 200 includes a spring configured to apply a neutral biasing force to the second shaft joint segment 540, e.g., to bias the end effector 200 toward an unarticulated configuration. Prepare more.

Surgical stapling assembly 500 further includes a closure drive shaft segment 575 and a firing drive shaft segment 576, each configured to transmit rotational motion to end effector 200 through articulation joint 520. Drive shaft segments 575, 576 are configured to passively expand and contract longitudinally as end effector 200 is articulated. Articulation causes drive shaft segments 575, 576 to expand and contract, allowing for longitudinal extension or contraction of the length of the drive shaft due to articulation of end effector 200. During expansion and contraction of the drive shaft segments 575, 576, the drive shaft segments 575, 576 maintain rotational driving engagement with the corresponding input and output shafts within the end effector 200. In at least one case, the output shaft includes a closure screw 251 and a firing screw 261, which are further described herein.

18-20 illustrate a surgical stapling end effector assembly 600 that includes a shaft portion 610 and an end effector 600. FIGS. End effector assembly 600 is similar in many respects to various other end effector assemblies disclosed herein, however, end effector assembly 600 includes multiple components driven by a flexible firing shaft. A firing member is provided. End effector assembly 600 is configured to cut and staple tissue. End effector assembly 600 may be attached to a surgical instrument handle and/or surgical robotic interface by proximal tab 611 of shaft portion 610. The surgical instrument handle and/or surgical robot interface may be configured to actuate various functions of end effector assembly 600. End effector assembly 600 includes a cartridge channel jaw 620 and an anvil jaw 660 pivotally mounted to cartridge channel jaw 620 to clamp tissue between cartridge channel jaw 620 and anvil jaw 660.

Cartridge channel jaw 620 includes a channel 630 including a proximal end 631 , a staple cartridge 640 configured to store a plurality of staples therein and configured to be received within channel 630 , and staple cartridge 640 . and a support brace 650 fitted therein. Staple cartridge 640 and support brace 650 are configured to be assembled together prior to installing staple cartridge 640 within channel 630. As discussed in more detail below, support brace 650 is configured to further support the firing member assembly as it is advanced through end effector assembly 600.

Anvil jaw 660 is configured to form staples ejected from staple cartridge 640. Anvil jaw 660 includes a proximal end 661 with a pair of pin holes 662 defined therein that are configured to receive coupling pins 663. Anvil jaw 660 is pivotable about coupling pin 663 between an unclamped position and a fully clamped position. A coupling pin 663 is also received within a pair of pin holes 633 defined in the proximal end 631 of the channel 630. Connecting pin 663 serves to pivotally attach anvil jaw 660 to channel 630. In at least one case, channel 630 is attached to shaft portion 610 by a retaining ring or band that fits around annular groove 632 of channel 630 and annular groove 615 of shaft portion 610. A retaining ring or band is configured to retain channel 630 to shaft portion 610.

End effector assembly 600 includes a closure driver 670 configured to grasp tissue between anvil jaw 660 and cartridge channel jaw 620 by pivoting anvil jaw 660 relative to channel 630. End effector assembly 600 also includes a firing driver 680 configured to clamp, staple, and cut tissue by deploying a plurality of staples from staple cartridge 640. Closure driver 670 includes a closure screw 671 disposed within channel 630 and a closure wedge 675 threadably coupled to closure screw 671. When closure screw 671 is rotated, closure wedge 675 is advanced distally or retracted proximally to open or close anvil jaws 660, respectively. Closure driver 670 may be actuated by any suitable means. For example, a rotational drive shaft may extend from the actuation interface through shaft portion 610, for example, to rotate closure screw 671. Other examples of suitable rotary drive shafts are described further herein.

Firing driver 680 includes a flexible drive shaft 681 configured to move linearly through end effector assembly 600. Flexible drive shaft 681 may be actuated, for example, by a robot input and/or a manually actuated drive shaft of a handle assembly. Flexible drive shaft 681 is configured to extend through hollow passageway 614 in distal end 613 of shaft portion 610 such that end effector assembly 600 is articulated relative to the shaft from which end effector 600 extends. Flexible as you get. A flexible drive shaft 681 extends through a clearance slot 676 defined in closure wedge 675 and is fixedly attached to lower firing member 682. Lower firing member 682 is configured to be reused with different staple cartridges.

Staple cartridge 640 hooks into engagement or latches with lower firing member 682 such that lower firing member 582 can push or drive upper firing member 683 through staple cartridge 640 and support brace 650. A disposable upper firing member 683 is provided. In other words, the firing actuation includes a two-part firing member, a disposable upper firing member 683 incorporated into the cartridge 640 and a reusable lower firing member 682 incorporated into the firing driver 680, which Cartridges 640 may be coupled together when seated within elongated channel 630. Two-piece firing members are further described herein.

Upper firing member 683 engages lower firing member 682 with an upper flange configured to engage and position anvil jaw 660 and a knife edge configured to cut tissue. and a latch portion configured to. Staple cartridge 640 further includes a thread 684 configured to engage a staple driver disposed within staple cartridge 640 to eject staples from staple cartridge 640. Because the knife and cutting edge are incorporated into the disposable upper firing member 683 of the staple cartridge 640, a new and/or unused cutting edge is provided with each staple cartridge loaded into the end effector assembly 600. Can be done.

Lower firing member 682 and upper firing member 683 are supported such that vertical loads associated with the firing sequence are configured to be distributed through support brace 650, staple cartridge 640, channel 630, and anvil jaw 660. It is configured to move via brace 650. Support brace 650 may be constructed of a metallic material that is inserted within staple cartridge 640, for example. Support brace 650 includes a key rail 655 configured to fit within a corresponding key slot defined within the longitudinal slot of staple cartridge 640. Support brace 650 includes a longitudinal slot 653 configured to receive a knife in upper firing member 683 , a portion of upper firing member 683 , a portion of lower firing member 682 , and flexible drive shaft 681 . and a cylindrical passageway 657 configured to receive. Support brace 650 further includes a vertical key extension 656 configured to be received within a corresponding keyhole in the cartridge deck. Such extensions are visible through the cartridge deck when support brace 650 is installed within staple cartridge 640. In at least one case, support brace 650 is configured to be inserted into staple cartridge 640 from the bottom of staple cartridge 640 facing channel 630.

Support brace 650 further includes a proximal tab 651 and a distal tab 653, both of which are configured to be engaged with channel 630. Tabs 651, 653 are configured to distribute at least a portion of the force transmitted through assembly 600 by firing driver 680 and corresponding components. Distal tab 651 shares and/or redistributes the load applied to support brace 650 by firing driver 680 with channel 630 so that upper firing member 683 and lower firing member 682 may function to prevent being pushed through the section.

Staple cartridge 640 is removed from channel jaw 630 when it is replaced so end effector assembly 600 can be reused. Removing staple cartridge 640 from channel jaw 630 removes upper firing member 683, sled 684, support brace 650, and staple cartridge 640. Unused knives can be provided with replacement staple cartridges.

Various embodiments disclosed herein may be used in conjunction with robotic system 700. Exemplary robotic systems are shown, for example, in FIGS. 21-23. FIG. 21 shows a master controller 701 that may be used in conjunction with a surgical robot, such as the robotic arm slave cart 800 depicted in FIG. 22, for example. Master controller 701 and robot arm slave cart 800 and their respective components and control systems are collectively referred to herein as robot system 700. Examples of such systems and devices are U.S. Pat. STAPLING INSTRUMENTS WITH ROTATABLE STAPLE DEPLOYMENT ARRANGEMENTS, each of which is incorporated herein by reference in its entirety. As is known, master controller 701 is typically held by a surgeon and manipulated in space while the surgeon views the procedure via stereo display 702 (represented generally as 703 in FIG. 21). controller). Controller 701 generally includes an actuatable handle, trigger, or actuator that preferably moves in multiple degrees of freedom and actuates the tool (e.g., to close the gripping jaws, apply an electrical potential to an electrode, etc.) A manual input device is often further provided.

As seen in FIG. 22, in one form, robotic arm cart 800 may be configured to operate one or more surgical tools, shown generally as 900. Various robotic surgical systems and methods utilizing a master controller and robotic arm cart configuration are disclosed in U.S. Patent No. 1, entitled "MULTI-COMPONENT TELEPRESENCE SYSTEM AND METHOD," the entire disclosure of which is incorporated herein by reference. No. 6,132,368.

In various forms, robotic arm cart 800 includes a base 702 that may support surgical tool 900 in the illustrated embodiment. In various forms, surgical tool(s) 900 may be supported by a series of manually articulatable linkages, commonly referred to as setup joints 804, and a robotic manipulator 806. In various embodiments, the linkage and coupling apparatus are described more completely in U.S. Pat. may facilitate rotation of a surgical tool about a point in space, as described in . This parallelogram arrangement limits rotation to pivoting about axis 812a, sometimes referred to as the pitch axis. The coupling supporting the parallelogram linkage is pivotally mounted to the setup joint 804 (FIG. 22), so that the surgical tool further rotates about axis 812b, also referred to as the yaw axis. Pitch axis 812a and yaw axis 812b intersect at a remote center 814 aligned along the elongate shaft of surgical tool 900. Surgical tool 900 may have additional driven degrees of freedom supported by manipulator 806, including sliding movement of surgical tool 900 along longitudinal axis "LT-LT." As surgical tool 900 slides along tool axis LT-LT relative to manipulator 806 (arrow 812c), remote center 814 remains fixed relative to base 816 of manipulator 806. Therefore, the entire manipulator is generally moved to reposition remote center 814. Linkage 808 of manipulator 806 may be driven by a series of motors 820. These motors actively move linkage 808 in response to commands from the control system's processor. Motor 820 may also be used to operate surgical tool 900. Alternative joint structures and setup configurations are also envisioned. Examples of other joints and setup devices are disclosed, for example, in U.S. Patent Application No. 5,878,193, entitled "AUTOMATED ENDOSCOPE SYSTEM FOR OPTIMAL POSITIONING," the entire disclosure of which is incorporated herein by reference. has been done.

Although data communications between the robotic components and the processor of the robotic surgical system are described herein primarily with reference to communications between the surgical tools and master controller 701, similar communications Component compatibility verification, component type identification, component calibration (offset, etc.) communication with manipulator circuits, setup junctions, endoscopes or other image capture devices, etc., components to robotic surgical systems It is to be understood that this may be done with the processor of the robotic surgical system, such as for confirmation of the connection of the robot. According to at least one aspect, the various surgical instruments disclosed herein may be used in conjunction with other robotically controlled or automated surgical systems and are not necessarily illustrated in FIGS. 21-23. , and is not limited to use with the specific robotic system components described in the aforementioned references.

During various laparoscopic surgical procedures, it is common to insert a surgical end effector portion of a surgical instrument through a trocar placed in the patient's abdominal wall to access a surgical site located within the patient's abdomen. This is a great method. In its simplest form, a trocar is a pen-shaped instrument with a sharp triangular tip at one end, typically used within a hollow tube known as a cannula or sleeve, to create an opening in the body and A surgical end effector may be introduced therethrough. Such devices form an access port within the body cavity through which a surgical end effector can be inserted. The inner diameter of the trocar cannula necessarily limits the size of the end effector and drive support shafts of surgical instruments that can be inserted through the trocar.

Regardless of the particular type of surgical procedure being performed, once the surgical end effector is inserted into the patient through the trocar cannula, in order to properly position the surgical end effector relative to the tissue or organ to be treated, It is often necessary to move a surgical end effector relative to a shaft assembly positioned within a trocar cannula. This movement or positioning of the surgical end effector relative to the portion of the shaft that remains within the trocar cannula is often referred to as "articulation" of the surgical end effector. To facilitate such articulation of surgical end effectors, various articulation joints have been developed for attaching surgical end effectors to associated shafts. As expected in many surgical procedures, it is desirable to use a surgical end effector that has as large a range of articulation as possible.

Due to the size constraints imposed by the size of the trocar cannula, the components of the articulation joint must be sized to be freely insertable through the trocar cannula. These size constraints also limit the number of drive members and components supported within the housing, which may be hand-held or may be part of a larger automated system, and which may be operatively associated with motors and/or other control systems. It also limits the size and configuration of components. Often these drive members must be operably coupled or operably passed through an articulation joint to be operatively associated with the surgical end effector. For example, one such drive member is commonly used to apply articulation control motion to a surgical end effector. In use, the articulation drive member is deactivated to position the surgical end effector in a non-articulating position to facilitate insertion of the surgical end effector through the trocar, and thereafter the surgical end effector is The surgical end effector can be actuated to articulate to a desired position upon entry into the patient.

Therefore, the aforementioned size constraints limit the development of an articulation system that can achieve the desired range of articulation and further accommodate the variety of different drive systems needed to operate the various features of the surgical end effector. These are many challenges. Further, once the surgical end effector is positioned in the desired articulation position, the articulation system and articulation joint must be able to hold the surgical end effector in that position during actuation of the end effector and performance of the surgical procedure. It won't happen. Such articulating joint devices must also be capable of withstanding external forces experienced by the end effector during use.

Various surgical instruments use a variety of different drive shaft configurations that function to transmit drive motion from a corresponding drive motion source supported by the handle of the surgical instrument or other part of an automatic or robotic control system. . These drive shaft configurations must be capable of accommodating significant articulation orientations of the end effector while effectively transmitting such drive motion across the articulation joint of the surgical instrument. Additionally, because of the size constraints mentioned above imposed by the size of the trocar into which the instrument shaft must be inserted, these drive shaft components must occupy as little space as possible within the shaft. To meet these demands, many drive shaft devices include several movable elements connected in series with each other. The small size (eg, 4 mm diameter) and number of components result in difficult and tedious assembly procedures that increase the cost and complexity of the device.

As further described herein, the powered stapling device includes two independently rotatable drive members, a first rotatable drive member configured to effect closure of the jaws of an end effector; , a second rotational drive member configured to effect firing of a staple cartridge disposed within the end effector. The first and second rotational drive members are flexible and configured to extend through the at least one articulation joint. In such an example, the first and second rotational drive members can transmit rotational actuation motion through the articulation joint(s) when in the unflexed configuration and when in the flexed configuration. Exemplary rotary drive members are described further herein.

The power stapling assembly includes a closure driver comprising a first jaw, a second jaw, a first rotary drive member extending through the articulation joint, and a second rotary drive member extending through the articulation joint. and a firing driver. The second rotational drive member may be rotatable independently from the first rotational drive member. The closure driver may be actuated, for example, by a closure trigger, wherein actuation of the closure driver results in rotation of the first rotary drive member, which rotates through the articulation joint onto the closure screw. transmit motion. The closure driver further includes a closure wedge threadably coupled to the closure screw, the closure wedge engaging the first jaw to place the first jaw in an open position upon rotation of the first rotary drive member. and is configured to be moved from the closed position to the closed position.

The firing driver may be actuated by a firing trigger that is separate from the closure trigger, for example. The rotation of the second rotary drive member is separate from the rotation of the first rotary drive member, and the closing motion is separate and different from the firing motion. Actuation of the firing driver causes rotation of the second rotational drive member, which transmits rotational motion to the firing screw through the articulation joint. The firing driver further includes a firing member threadably coupled to the firing screw, the firing member cammingly engaging the first jaw and the second jaw and firing the cutting member upon rotation of the second rotational drive member. and/or configured to move the staple firing sled.

In various cases, at least one component within the power stapling device can be a 3D printed component. 3D printed components may be incorporated into articulation systems, closure/grasping systems, and/or firing systems, as further described herein. 3D printing technology can be used to improve the capabilities of components in certain cases. For example, 3D printing can enable printed components to exhibit metamaterial properties, such that 3D printed components allow precision in the formation of small detailed features, e.g. Exhibits greater structural strength and stiffness while optimizing other properties of the component such as selective flexibility and/or lubricity. Exemplary 3D printed components for motorized stapling devices are further described herein and include flexible rotatable drive member(s), such as serial 3D printed universal fittings, including a firing member or I-beam and/or a staple cartridge and/or subcomponents thereof. In one example, the staple cartridge may be a composite plastic-metal 3D printed component. 3D printing of various components and considerations therefor are further described herein.

Methods of stapling using such surgical stapling assemblies are also contemplated. The method can include obtaining a surgical stapling assembly and actuating a closure driver with a closure trigger, the closure wedge engaging the first jaw to generate the first rotational drive. The first jaw is configured to move from an open position to a closed position upon rotation of the member. The method may further include actuating a firing driver with a firing trigger, the firing member cammingly engaging the first jaw and the second jaw to fire upon rotation of the second rotary drive member. The cutting member is configured to advance the cutting member and the staple firing sled during the movement. Various uses of 3D printed components in such assemblies are further described herein.

In various cases, a surgical end effector and/or stapling assembly for a surgical device can include a rotary drive screw or rotary drive member, as further described herein. The rotational drive screw may extend through the channel and/or a portion of the staple cartridge to a distal location within the end effector. The rotary drive screw can facilitate clamping and/or firing of the staple cartridge, as further described herein. The rotational drive screw can extend along a longitudinal axis and can be aligned with a centerline of the staple cartridge extending from a proximal end to a distal end of the staple cartridge.

The rotational drive screw through the end effector can occupy a significant portion of the limited area along the central longitudinal portion of the end effector and its staple cartridge. In various cases, the rotary drive screw may interfere with certain existing firing components, such as, for example, drivers and/or sleds. The small footprint of staple cartridges and the significant firing forces applied to the end effector and various components within the staple cartridge pose various challenges for structural deformation and/or repositioning of certain components. obtain.

For example, a firing component(s) in a staple cartridge that has a rotational drive screw therethrough may be exposed to firing force during the firing stroke to minimize damage to the component and/or misfiring of staples. It needs to be modified to avoid interference and provide sufficient clearance around the rotational drive screw while bearing and balancing torque. In various cases, the rows of staples are compressed (i.e., a denser staple arrangement) and/or shifted laterally outwardly away from the rotational drive screw to create a row of staples laterally about the centerline of the staple cartridge. Space can be increased. Repositioning and/or increasing the density of staple rows may require different adaptations to firing components, such as drivers and/or sleds, for example.

In various cases, the driver and/or sled may be modified to accommodate repositioned and/or compressed staple rows while minimizing the occurrence of jams and/or misfires. Modifications to the staple driver may include, for example, structural and geometrical changes to the staple struts and/or the bridges therebetween. In certain cases, the upper portion of the driver (eg, the width of the staple post) may be asymmetric with respect to the centerline of the driver. Additionally or alternatively, the lower portion of the driver (eg, the bridge and/or base of the staple post) can be asymmetrical with respect to the centerline of the driver.

For example, in one aspect of the present disclosure, a staple cartridge may include a body extending along a longitudinal axis, a row of staples, and a triple driver configured to fire three staples simultaneously. The rows of staples can include an inner row on the first side of the longitudinal axis, and the inner row includes inner staples. The rows of staples can also include an intermediate row on the first side of the longitudinal axis, where the intermediate row includes intermediate staples. Further, the rows of staples can include an outer row on the first side of the longitudinal axis, the outer row including outer staples. The middle row may be equidistantly spaced from the inner and outer rows. The triple driver can include an inner post defining a first width, the inner post configured to support an inner staple. The triple driver can also include an intermediate strut defining a second width, the intermediate strut configured to support an intermediate staple. Further, the triple driver can include an outer strut defining a third width, the outer strut being configured to support an outer staple. The first width can be smaller than the second width and smaller than the third width. In certain cases, the first width, second width, and/or third width can be different.

In various aspects of the present disclosure, the varying widths of the staple struts of the multi-staple driver provide more space for the thread rails while providing rotational drive screws along the central longitudinal portion of the staple cartridge. Can be configured to optimize area. For example, various improvements to staple cartridges, including drivers and cartridge bodies, and their advantages are further described herein.

24 and 25, staple cartridge 20100 includes a body 20102 that extends along longitudinal axis A. Referring now to FIGS. The staples are removably disposed within the body 20102. The staple may be ejected from the body 20102 and into tissue, for example, during a firing stroke. The staples are arranged in longitudinal rows on either side of longitudinal axis A. Cartridge body 20102 also includes a deck 20104, which may be referred to as a tissue support surface, for example. Deck 20104 is a laterally curved tissue support surface that defines a curved surface or contour from a first lateral side of body 20102 to a second lateral side of body 20102. A peak of the laterally curved tissue support deck 20104 is defined in the middle portion of the body 20102. The peaks can, for example, be located between longitudinal rows of staples and cover the longitudinal axis A. In various cases, a rotational drive screw, such as firing screw 261 (FIGS. 4 and 5), extends through a portion of staple cartridge 20100, as further described herein.

The staples are disposed within cavities 20110 defined within cartridge body 20102. The staples are arranged in longitudinal rows on either side of the longitudinal axis A. For example, cavities 20110 are arranged in cavity row 20112. The cavity rows include, on each side of longitudinal axis A, an inner row 20112a, a middle row 20112b, and an outer row 20112c. Middle row 20112b is equidistantly spaced between inner row 20112a and outer row 20112c. For example, inner cavity row 20112a may be laterally spaced inwardly a distance from intermediate cavity row 20112b, and outer cavity row 20112c may be laterally spaced outwardly the same distance from intermediate cavity row 20112b. can. A rotational drive screw can be aligned with longitudinal axis A and can extend through cartridge body 20102 adjacent inner cavity row 20112a. The rotational drive screw can be between and parallel to the inner cavity row 20112a, for example.

Inner row 20112a holds inner staples, middle row 20112b holds middle staples, and outer row 20112c holds outer staples. In various cases, the inner staple, intermediate staple, and outer staple can be the same. In other examples, the inner staple, intermediate staple, and/or outer staple may each differ, for example, with respect to staple type (eg, wire or stamp), material, and/or size (eg, different heights). The reader will appreciate that various staples, staple cavities, staple drivers, and staple cartridges are described herein. However, in certain instances, alternative fasteners may be utilized, and such fasteners may be incorporated into the fastener cavity, driven by a fastener driver, and/or in many aspects described herein. The staple cavity, staple driver, and/or staple cartridge may be fired from a fastener cartridge that may be similar to the staple cartridge described in .

Staple cartridge 20100 may have different placements of staples. For example, the staple cartridge 20100 may have less than three rows of staples on each side of longitudinal axis A, and in one aspect may have only two rows of staples on each side of longitudinal axis A. good. In yet other examples, staple cartridge 20100 can include four or more rows of staples on one or more sides of longitudinal axis A. In various examples, the rows of staples may be asymmetrical about longitudinal axis A. For example, a first side of staple cartridge 20100 may have a different number of staple rows than a second side of staple cartridge 20100.

Each staple cavity 20110 includes a proximal end, a distal end, and a lateral guide surface intermediate the proximal and distal ends. Staple cavity 20110 is constructed and dimensioned to guide driver 20120 through staple cavity 20110 and toward deck 20104. More specifically, the shape of staple cavity 20110 can complement the shape of driver 20120. For example, a lateral guide surface within each staple cavity 20110 is configured to guide a sidewall 20134 of the driver 20120 (e.g., a sidewall of a staple post) as the driver 20120 moves through the staple cavity 20110. . Additionally or alternatively, the proximal and/or distal ends of each staple cavity 20110 are uprights configured to slidably receive the ends and/or tongues of the driver 20120. May include grooves. Alternative tongue and groove configurations are also contemplated that may be configured to guide driver 20120 through staple cavity 20110 during firing of staples from staple cartridge 20100.

Driver 20120 is configured to support and drive a plurality of staples from cartridge body 20102 during a firing stroke. Driver 20120 can movably support staples spanning two or more longitudinal rows of staple cavities 20112. For example, driver 20120 can movably support inner staples, intermediate staples, and outer staples on the same side of staple cartridge 20100.

Referring now primarily to FIGS. 26-28, driver 20120 is shown. Multiple drivers, such as driver 20120, are incorporated into staple cartridge 20100, for example. Driver 20120 is a triple driver configured to drive three staples simultaneously. The driver 20120 includes three struts: an inner strut 20122a configured to support the inner staples in the inner row of staples; and an inner strut 20122a configured to support the intermediate staples in the middle row of staples. an intermediate post 20122b laterally outward of intermediate post 20122a; and an outer post 20122c laterally outward of intermediate post 20122b and configured to support an outer staple in the outer row of staples. The struts 20122a, 20122b, 20122c of each driver 20120 may be longitudinally staggered in various cases.

Driver 20120 also includes a bridge 20126 extending between adjacent posts 20122. For example, a first bridge 20126a extends between an inner strut 20122a and an intermediate strut 20122b, and a second bridge 20126b extends between an intermediate strut 20122b and an outer strut 20122c. Bridges 20126a, 20126b each include an angled lower surface 20128 configured to be drivingly engaged by the sled during the firing stroke. Stated another way, each driver 20120 is configured to be engaged and lifted by two parallel threaded rails along the sloped lower surface 20128 of the driver 20120. For example, the sled may be configured to move along a firing path during a firing stroke. The thread has a central portion aligned with the longitudinal axis A and a first portion on a first side of the longitudinal axis A configured to drivingly engage the sloped lower surface 20128 of the first bridge 20126a. and a second rail on a second side of the longitudinal axis A that is configured to drivingly engage the sloped lower surface 20128 of the second bridge 20126b. The sled and its firing motion are further described herein.

Each strut 20122 includes a proximal end 20130, a distal end 20132, and a pair of opposing sidewalls 20134 extending longitudinally between the proximal end 20130 and the distal end 20132. The sidewalls 20134 are configured to slidably engage a lateral guide surface within the respective staple cavity 20110 during firing motion. Each post 20122 includes a staple support cradle 20124. The base of the staple may be held within the staple support cradle 20124.

Staple support cradles 20124 are each aligned with one of inner axis A1, intermediate axis A2, or outer axis A3, and inner axis A1, intermediate axis A2, or outer axis A3 is on one side of staple cartridge 20100. It corresponds to an axis that defines the longitudinal rows of staples and staple cavities 20110. A first lateral distance D1 is defined between the inner axis A1 and the intermediate axis A2, and a second lateral distance D2 is defined between the outer axis A3 and the intermediate axis A2. The axes are equidistantly spaced, and the first lateral distance D1 and the second lateral distance D2 are the same. The lateral distances D1, D2 between the axis and adjacent rows of staple cavities 20110 are the same, but the driver 20120 is asymmetrical with respect to the centerline of the driver 20120. For example, the centerline of driver 20120 corresponds to intermediate axis A2, and the inner and outer staples are disposed equidistant from intermediate axis A2, however, driver 20120 is not symmetrical about intermediate axis A2.

Referring primarily to FIG. 27, the inner strut 20122a defines a first width Wa between its sidewalls 20134, the intermediate strut 20122b defines a second width Wb between its sidewalls 20134, and the outer strut 20122c defines a second width Wb between its sidewalls 20134. , defining a third width Wc between the sidewalls 20134 thereof. The first width Wa is different from the second width Wb and the third width Wc. For example, first width Wa may be reduced or narrowed to less than second width Wb and less than third width Wc to accommodate a rotational drive screw through a central portion of staple cartridge 20100. In certain examples, the one or more narrower struts 20122 maximize the width of the bridge 20126 and thus, for example, engage the sloped lower surface 20128 of the bridge 20126 to deliver firing force to the driver 20120. The footprint of the driver 20120 can be effectively narrowed and reduced while maximizing the width of the thread rail. In various cases, increasing the width of the bridge 20126 and sled rail can improve sled rail stiffness and minimize sled deformation and/or damage during the firing stroke.

The widths Wa, Wb, and Wc are all different. For example, the width Wb of the intermediate support 20122b is wider than the width Wa of the inner support 20122a and the width Wc of the outer support 20122c. The width Wc is smaller than the width Wb of the intermediate support 20122b and wider than the width Wa of the inner support 20122a. The different widths Wa, Wb, and Wc of the driver 20120 can be used, for example, to accommodate a rotational drive screw along the longitudinal axis A while effectively transmitting firing force and minimizing torque and false firing. Configured to optimize width.

As provided herein, in certain examples, the width of the staple post on the driver can be varied to accommodate a rotational drive screw disposed within the staple cartridge. Additionally or alternatively, in certain aspects of the present disclosure, the lower portion of the driver may also vary laterally, with the lower portion (e.g., the strut and/or bridge lower portion) It may also be asymmetrical with respect to the centerline through the strut. For example, the lower portion of the driver may be modified to increase the available area in the central longitudinal portion of the staple cartridge. The asymmetrical shape of the lower portion of the driver can be selected to improve the strength and stiffness of the triple driver while minimizing the height of the driver. In various cases, the strut thickness and/or bridge shape may vary laterally, but the struts may be equally spaced from the center of gravity of the substantially triangular triple driver. For example, the intermediate strut can be longitudinally aligned with the center of gravity, and the inner and outer struts can be longitudinally offset from the center of gravity. In various cases, the ramps may be equidistantly spaced from the center of gravity of the triple driver.

29 and 30, an end effector 20240 is shown that includes a staple cartridge 20200 and a triple driver 20220. Staple cartridge 20200 is similar in many aspects to staple cartridge 20100 (FIG. 24), and triple driver 20220 is similar in many aspects to triple driver 20120 (FIG. 26). For example, staple cartridge 20200 includes a cartridge body 20202 that includes three rows of staple cavities on each side of a rotary drive screw 20242, and triple driver 20220 includes three parallel staple support cradles 20224 configured to support staples. The triple driver 20220 is configured to fire staples from an inner row, a middle row, and an outer row.

End effector 20240 includes a rotational drive screw 20242 and a firing member 20244, which are similar to firing screw 261 (FIGS. 4 and 5) and firing member 270 (FIGS. 4 and 5), respectively. Firing member 20244 is configured to move through staple cartridge 20200 during a firing stroke to advance the sled and lift driver 20220. Driver 20220 includes an inner strut 20222a, an intermediate strut 20222b, and an outer strut 20222c. Posts 20222 include different widths, as described further herein. In various aspects of the present disclosure, one or more of the columns 20222 may also include a different height than other columns. In various cases, the different heights are configured to form the staples at different heights, which may correspond, for example, to the contour of a laterally curved tissue support surface or deck of the cartridge body.

The lower portion of driver 20220 includes a chamfered inner edge 20236. The chamfered inner edge 20236 is a notched or scalloped edge dimensioned to accommodate the drive screw 20242 and the lower portion of the firing member 20244. For example, drive screw 20242 extends along longitudinal axis A and is disposed between drivers 20220 on opposite sides of longitudinal axis A. In such a case, drive screw 20242 may extend through staple cartridge 20200 while minimizing the dimensions of staple cartridge 20200 and end effector 20240. Chamfered inner edge 20236 includes a cutout to the base portion of inner strut 20222a, which provides clearance for a firing component located along the longitudinal center portion of end effector 20240. Further, the chamfered inner edge 20236 is configured to provide space closer to the vertical centerline of the end effector, i.e., equidistant between the upper and lower cams, which is more likely to occur during the firing stroke. Force balance can be improved and/or assisted.

Additionally or alternatively, the bridge of the driver may vary laterally and/or be asymmetrical with respect to a centerline through the intermediate strut of the driver. Referring now to FIG. 31, an end effector 20340 is shown that includes a staple cartridge 20300 and a triple driver 20320. Staple cartridge 20300 is similar in many aspects to staple cartridge 20100 (see FIG. 24), and triple driver 20320 is similar in many aspects to triple driver 20120 (see FIG. 26). For example, staple cartridge 20300 includes a cartridge body 20302 and a deck 20304, three rows of staple cavities are disposed on each side of a rotary drive screw, and triple driver 20320 includes three parallel rows of staple cavities configured to support staples. Including a staple support cradle 20324, the triple driver 20320 is configured to fire staples from an inner row, a middle row, and an outer row. Driver 20320 is shown in a firing configuration in FIG. 31 with the upper portion of the staple post extending through deck 20304 (ie, staple overdrive).

End effector 20340 may include a rotational drive screw and a firing member. As further described herein, the firing member moves through staple cartridge 20300 during a firing stroke to advance sled 20350 with rail 20352 and lift driver 20320. Driver 20320 includes an inner strut 20322a, an intermediate strut 20322b, and an outer strut 20322c. Posts 20322 include different widths, as described further herein. In various aspects of the present disclosure, one or more of the columns 20322 can also include a different height than other columns, as further described herein.

The lower portion of driver 20320 includes a chamfered inner edge 20336 that is similar in many ways to chamfered edge 20236 (FIG. 29). The lower portion of driver 20320 also includes a bridge 20326 between adjacent staple posts 20322. A first bridge 20326a connects the inner strut 20322a to the middle strut 20322b, and a second bridge 20326b connects the middle strut 20322b to the outer strut 20322c. The shape of the first bridge 20326a is different from the shape of the second bridge 20326b. Stated another way, the bridge 20326a is asymmetric with respect to the vertical plane P (FIG. 31) through the driver 20320 and is aligned with the axis of the intermediate staple base/crown supported thereon.

The first bridge 20326a is higher than the second bridge 20326b. In various cases, as further described herein, the central longitudinal portion of the staple cartridge 20300 is higher than the height along the sides of the staple cartridge 20300 and the peak of the laterally curved tissue support surface. A greater height can be defined at the. As a result, staple cartridge 20300 accommodates additional material and/or increased height/volume of driver 20320 between inner strut 20322a and intermediate strut 20322b than between outer strut 20322c and intermediate strut 20322b. be able to. The increased height of the first bridge 20326a from the base surface compared to the second bridge 20326b can compensate for stiffness losses resulting from the chamfered inner edge 20336, for example. Additionally or alternatively, the height a of the first bridge 20326a compared to the second bridge 20326b minimizes the dimensions of the staple cartridge 20300 and end effector 20340 while maintaining a compact form factor. The stiffness and strength of triple driver 20320 can be improved.

In certain cases, the upper portion of the first bridge 20326a may be configured to guide the driver 20320 through the staple cavity during an initial portion of the firing motion through the staple cavity. For example, when the inner post 20322a is in the unfired position, the inner post 20322a is at least partially supported by the lateral guide surface due to the notch in the central portion of the cartridge body assembly 20300 to accommodate the rotational drive screw. or may not be guided. Without certain lateral support surfaces around the inner strut 20322a, the driver 20320 may be susceptible to torque and/or misfiring. However, the increased height of the first bridge 20326a is configured to engage an upright support surface within the cartridge body during the initial portion of the firing motion to improve guidance and support of the driver 20320. obtain.

Referring now to FIG. 32, an alternative driver shape for driver 20420 is shown. Driver 20420 is a triple driver and is similar in many aspects to triple driver 20120 (FIG. 26). For example, triple driver 20420 includes three parallel staple support cradles 20424 configured to support staples, and triple driver 20420 is configured to fire staples from an inner row, a middle row, and an outer row. Ru. Driver 20420 may be incorporated into various staple cartridges disclosed herein. For example, driver 20420 may be utilized with a staple cartridge adapted to receive a rotational drive screw extending along a longitudinal axis and a variable height deck.

Driver 20420 includes an inner strut 20422a, an intermediate strut 20422b, and an outer strut 20422c. Posts 20422 include different widths, as described further herein. In various aspects of the present disclosure, one or more of the struts 20422 can also include a different height than other struts, as further described herein.

The lower portion of driver 20420 includes a chamfered inner edge 20436 that is similar in many ways to chamfered edge 20236 (FIG. 29). The lower portion of driver 20420 also includes a bridge between adjacent staple posts 20422. A first bridge 20426a connects the inner strut 20422a to the middle strut 20422b, and a second bridge 20426b connects the middle strut 20422b to the outer strut 20422c. A variation to the shape of the lower portion of driver 20420 is shown in dashed lines in the schematic diagram of FIG. 32. For example, driver 20420 is used to provide adequate space and clearance along the central longitudinal portion of the staple cartridge for rotary drive screw 20442, which is similar in many aspects to firing screw 261 (FIGS. 4 and 5). includes a chamfered inner edge 20436 and an upper gusset 20438 between the first bridge 20426a and the inner post 20422a. In such a case, driver 20420 can provide space and clearance for rotary drive screw 20442 while maintaining sufficient structural integrity and rigidity to properly transfer firing loads.

In various cases, the highest height of the variable height deck and staple cartridge may be adjacent to the rotary drive screw 20442. In such cases, a narrower tissue gap can be defined along the firing bar and cutting edge. The portion of the variable height deck that covers the inner struts 20422a and/or the first bridge 20426a can define a maximum height, thus, in certain aspects, the raised first bridge 20426a and/or the gussets 20438 can be fitted intermediate the first bridge 20426a and the inner post 20422a.

In certain examples, one or more gusset plates can extend between the upper edge of the first bridge 20426a and the inner post 20424. In certain examples, gusset 20438 can include longitudinal gusset ribs along at least a portion of the length of inner strut 20422a and first bridge 20426a. The driver 20420 is asymmetric with respect to a vertical plane P (FIG. 32) through the intermediate post 20422b and is aligned with the longitudinal axis of the staple base supported therein. For example, first bridge 20426a can define a different shape and a different cross-sectional profile than second bridge 20426b due to gussets 20438 and/or chamfered inner edges 20436.

In certain instances, a portion of the cartridge body can be cut away to accommodate a rotational drive screw along a central portion of the staple cartridge. The cartridge body may include additional guide and support mechanisms configured to guide the driver through the staple cavity and toward the deck of the cartridge body. The guide may be configured to engage and support the driver even if a portion of the driver is not fully seated within the staple cavity.

Referring to FIGS. 33 and 34, cartridge body 20502 is shown. In various cases, cartridge body 20502 can be similar in many aspects to cartridge body 20102 (FIG. 24) and can be incorporated within staple cartridge 20100 and use driver 20120 (FIG. 26). Staples may be disposed within cavities 20510a, 20510b, 20510c defined within cartridge body 20502. The staples are arranged in longitudinal rows on either side of longitudinal axis A along the centerline of cartridge body 20502. For example, cavities 20510a, 20510b, 20510c are arranged in a cavity row. The cavity rows include an inner row 20512a, a middle row 20512b, and an outer row 20512c on each side of the longitudinal axis. A rotational drive screw (eg, firing screw 261 in FIGS. 4 and 5) can be aligned with longitudinal axis A and can extend through cartridge body 20502 adjacent inner cavity row 20512a. The rotational drive screw can be between and parallel to the inner cavity row 20512a, for example.

Referring primarily to FIG. 34, cartridge body 20502 includes a guide surface 20514 that extends around an inner cavity 20510a within inner row 20512a. In various cases, the guide surface 20514 guides the driver (e.g., the inner strut 20122a of the triple driver 20120) into the inner cavity 20510a even if the inner strut 20122a is not fully seated within the inner cavity 20510a prior to firing. It is configured to be guided inside and passed through. In various cases, the guide surface 20514 is a circumferential chamfer on the lower cartridge surface that extends around the inner cavity 20510a. Such circumferential chamfer is configured to prevent inadvertent binding and hang-up when the driver's inner strut is advanced into the inner cavity 20510a. In other examples, guide surface 20514 can include, for example, a fillet. The guide surface 20514 can extend around the entire circumference of the inner cavity 20510a. In other examples, the guide surface 20514 may be disposed about a portion of the periphery, such as the first lateral side, the proximal end, and/or the distal end.

Referring also to FIG. 35, a portion of the inner cavity 20510a and driver 20120 is shown. The lower edge of the inner cavity 20510a includes a guide surface 20514 that extends around the circumference of the inner cavity 20510a. The upper edge of the inner strut 20122a also supports the inner strut 20122a even when the inner strut 20122a is not fully seated within the inner cavity 20510a prior to the firing stroke and initial lifting of the driver 20120 by the sled. Includes a guide surface 20125 configured to guide into alignment with the inner cavity 20510a. In such an example, guide surfaces 20514, 20125 on the lower edge of inner cavity 20510a and the upper edge of inner strut 20122a, respectively, facilitate smooth movement of inner strut 20122a into inner cavity 20510a during the firing stroke. configured to interact to ensure that As further described herein, the inner post 20122a is inserted into the inner cavity 20510a prior to the firing stroke due to the space required by the rotational drive screw along the central longitudinal portion of the cartridge body 20502. It does not have to be fully seated.

Referring now to FIGS. 36 and 37, a portion of driver 20620 is shown. In various aspects of this disclosure, driver 20620 may be a triple driver and may be similar in many aspects to driver 20120 (FIG. 26). Driver 20620 can be incorporated into staple cartridge 20100 (FIG. 24) in various aspects of the present disclosure. Driver 20620 includes a post 20622 configured to support staples 20680 (FIG. 37). The strut 20622 includes a proximal end 20630, a distal end 20632, and a pair of opposing sidewalls 20634 extending longitudinally between the proximal end 20630 and the distal end 20632. Sidewalls 20634 are configured to slidably engage a lateral guide surface within the respective staple cavity. Post 20622 also includes a staple support cradle 20624 in which the base of staple 20860 may be retained.

Driver 20630 further includes proximal and distal upright features 20636, 20638 or extensions that extend away from the base of driver 20630 and away from staple support cradle 20624. Proximal upright feature 20636 is the most proximal feature of strut 20622 and extends from proximal end 20630 of strut 20622. Distal upright feature 20638 is the most distal feature of strut 20622 and extends from distal end 20636 of strut 20622. In the unfired position of the driver, the proximal and distal upright features 20636, 20638 may be below and extend toward the deck of the staple cartridge. The proximal and distal upright mechanisms 20636, 20638 can be configured, for example, to support the staple 20680 and guide the staple legs during formation.

Proximal and distal upright features 20636, 20638 are the highest portions of strut 20622. In certain cases, when the driver is moved to the firing position, the proximal and distal upright features 20636, 20638 extend above the deck to facilitate grasping and/or retention of tissue adjacent the staple 20860. Can be done. For example, the proximal and distal upright mechanisms 20636, 20638 can grasp tissue at the proximal and distal ends of the staple cavity. Additionally, the proximal and distal upright features 20636, 20638 can act as guide surfaces for the driver 20630 and, in certain examples, can guide the strut 20632 into the fastener cavity. For example, when the strut 20622 is not fully seated within the staple cavity prior to firing, the proximal and distal uprighting mechanisms 20636, 20638 guide the strut 20622 during the firing motion, as further described herein. and is configured to align the staple cavity with the staple cavity.

In certain cases, the proximal and distal upright mechanisms 20636, 20638 may be incorporated into the inner strut (ie, the strut adjacent to the firing path and/or rotational drive screw). In such a case, the proximal and distal upright mechanisms 20636, 20638 can engage the staple cavity during the firing stroke such that the inner strut is positioned within the staple cavity prior to firing, as further described herein. configured to guide the inner post even when not fully seated. In other examples, the intermediate strut and/or the outer strut can also include at least one of a proximal uprighting feature 20636 and/or a distal uprighting feature 20638.

Certain aspects of the present disclosure provide that the proximal and distal upright mechanisms 20636, 20638 are configured to be received within a recess along the underside of the tissue support deck when the driver 20620 is in the fully advanced position. . As further described herein, the lower surface of the tissue support deck can include an array of recesses that fit within pocket extensions on the anvil-facing side of the deck. The pocket extension can surround or at least partially surround the opening in the tissue support deck to grip the tissue and/or guide the staple legs during the firing stroke. Nesting features on the driver with underside recesses in the tissue support deck is further described herein. By nesting the proximal and distal upright features within pocket extensions or ridges of the cartridge deck, desired tissue spacing and deck thickness can be maintained in various cases.

In certain examples, a replaceable staple cartridge may be used on each firing stroke and then replaced with another replaceable staple cartridge for a subsequent firing stroke. A replaceable staple cartridge may include a cartridge body, a driver, staples, and a thread, as further described herein. A reusable multi-fire cutting edge is incorporated into the end effector and can be advanced against the replaceable staple cartridge in certain instances. For example, the end effector can include a firing member, such as an I-beam or an E-beam, having a distally directed upright cutting edge along its leading edge. An exemplary firing member having a reusable cutting edge for use during multiple firing strokes is further described herein. In certain instances, reusable knives and their cutting edges can be hardened parts that can be expensive to manufacture. In certain instances, placing a reusable knife within a surgical device may limit the number of times the surgical device can be reused. Furthermore, to resist dulling of the knife from multiple shots, reusable knives may not be as sharp as single-use knives in certain cases.

In other examples, the firing member, end effector, and/or surgical device may not include a multi-fire tissue ablation knife. For example, instead of being incorporated into the surgical device itself, the knife may be incorporated into, for example, a replaceable staple cartridge. In such instances, a fresh cutting edge may be used with each firing stroke.

Various replaceable staple cartridge assemblies with tissue cutting knives are described herein. In one case, the firing member can include an integral threaded component and the knife is releasably attached to the firing member upon insertion of the staple cartridge into the surgical device having the firing member or its end effector. can be attached or mounted.

Referring now to FIG. 99, an end effector 20840 is shown having a firing member 20841 with an integral thread 20860 and an attachment mechanism (eg, recess 20846) for connecting to a single use knife 20830. End effector 20840 is similar in many aspects to end effector 200 (see FIGS. 4 and 5) and is configured to cut and staple tissue of a patient. For example, end effector 20840 includes a cartridge jaw 20850 having opposing sidewalls 20852, and end effector 20840 also includes an anvil jaw 20854. Cartridge jaw 20850 is configured to receive a staple cartridge, such as, for example, replaceable staple cartridge 20800 shown in FIG. 103. The end effector 20840 also includes a firing drive system 20839 that includes a rotary drive screw 20842 (FIG. 105) and a firing member 20841, which respectively fire screw 261 (FIGS. 4 and 5) and firing member 270 (FIGS. This is the same as 5). Firing member 20841 is driven through end effector 20840 as rotary drive screw 20842 rotates during a firing stroke to fire staples from staple cartridge 20800. Rotary drive screw 20842 extends along longitudinal axis A through fastener cartridge 20800.

100A, firing member 20841 includes an upright body portion 20843, an upper cam member 20844 extending laterally from opposite sides of upright body portion 20843, and a lower cam member 20844 extending laterally from opposite sides of upright body portion 20843. member 20845. When end effector 20840 is in the clamped configuration (FIG. 105), upper cam member 20844 is configured to cam engage anvil jaw 20854 of end effector 20840 during the firing stroke, and lower cam member 20845 is configured to cam engage anvil jaw 20854 of end effector 20840 during the firing stroke. The cartridge jaw 20850 of the end effector 20840 is configured to cam engage the cartridge jaw 20850 of the end effector 20840 therein. Upper and lower cam members 20844, 20845 clamp the jaws of end effector 20840 and release tissue during the firing stroke, as further described herein with respect to various firing members (e.g., I-beams and E-beams). configured to define a gap. A threaded opening 20847 through upright body portion 20843 is configured to receive a rotational drive screw 20842 therethrough. In other examples, a threaded nut may be threadably coupled to the rotational drive screw 20842 and mounted to the firing member 20841. Various threaded nuts and alternative firing members are further described herein.

Still referring to FIG. 100A, firing member 20841 further includes an integrated thread 20860. Sled 20860 has two rails 20866. One of the rails 20866 is configured to engage a row of staple drivers on each side of the surgical end effector 20800. Stated another way, sled 20860 includes a single rail 20866 for each side of surgical end effector 20800, ie, for each side of staple cartridge 20800 (FIG. 103). A single rail on each side can save lateral space within the surgical end effector 20840, which can be added along the central portion of the surgical end effector 20840 to accommodate the rotational drive screw 20842. space can be provided. In such a case, sled 20860 may be a reusable component provided with firing member 20841 and the surgical device, for example.

Referring primarily to FIG. 103, firing member 20841 is driven through staple cartridge 20800, which includes a cartridge body 20802 and drivers 20820, 20821 movably disposed therein. Driver 20820 is a triple driver and driver 20821 is a double driver. In various cases, the most proximal drivers within staple cartridge 20800 are double drivers 20821; in other cases, one or more of the most proximal drivers may be a single driver. Double driver 20821 includes a lateral flange that includes a sloped surface for driving engagement by threaded rail 20866 that also aligns with sloped recess 20818 (FIG. 102) on triple driver 20820. Stated another way, double driver 20821 and triple driver 20820 are both driven by a single threaded rail 20866 on each side of fastener cartridge 20800.

Parallel longitudinal slots 20803 (FIG. 103) through cartridge body 20802 are dimensioned to receive rails 20866 during the firing stroke. Stated another way, as the upright body portion 20843 of the firing member 20841 moves through the central longitudinal slot 20808 in the cartridge body 20802, the rail 20866 moves along the parallel slot 20803 along the underside of the cartridge body 20802. and move. The parallel longitudinal slots 20803 are also parallel to the longitudinal slots 20808 from which the upright body portion 20843 of the firing member 20841 projects.

In other examples, the integral sled of firing member 20841 may have more than one rail on each side. For example, integrated threads with four rails and six rails are also envisioned.

Firing member 20841 is adapted to releasably connect to knife 20830. Knife 20830 includes opposed spring arms 20832 that extend proximally toward and resiliently engage upright body portion 20843 of firing member 20841. Spring arm 20832 is snapped around upright body portion 20843 and extends into a cavity 20846 defined within upright body portion 20843. Knife 20830 also includes a longitudinal body 20834 that rests and/or nests on a complementary surface on firing member 20841 above threaded opening 20847 for rotary drive screw 20842, for example. It is configured so that Knife 20830 further includes an upright cutting edge 20836 configured to extend above tissue support deck 20804 (FIG. 105) to cut tissue during the firing stroke.

In various cases, fastener cartridge 20800 and cartridge jaw 20850 may include alignment and/or leverage features to facilitate installation of fastener cartridge 20800 within cartridge jaw 20850. Various alignment and leverage mechanisms are further described herein. These features can also align the knife 20830 with the firing member 20841 and, more specifically, align the spring arm 20832 with the cavity 20846 so that the knife 20830 can be aligned with the firing member 20841 and, more particularly, the spring arm 20832 can be aligned with the cavity 20846 so that the knife 20830 can 20830 can be ensured to be connected to firing member 20841.

In the unfired staple cartridge 20800, the knife 20830 is aligned with the indicator sled 20828, and the indicator sled is configured to be pushed distally by the knife 20830 during the firing stroke. As further described herein, the indicator sled 20828 is activated during the firing stroke by moving into the window 20806 (FIG. 114) in the nose of the cartridge body 20802, as further described herein. Upon completion, provide a visual indication to the clinician and/or user. Additionally, indicator sled 20808 is configured to selectively overcome lost and/or spent cartridge lockout in certain cases, as further described herein.

Indicator thread 20828 and knife 20830 are components of staple cartridge 20800. When staple cartridge 20800 is installed within surgical end effector 20840, knife 20830 is aligned with firing member 20841 such that spring arm 20832 resiliently engages opening 20846. The insertion angle of staple cartridge 20800 is configured to ensure proper alignment of spring arm 20832 and opening 20846. In such an example, a fresh knife may be provided with each staple cartridge 20800 for each firing stroke.

Referring primarily to FIGS. 100B and 101, integral sled 20862 is configured to drivingly engage triple driver 20820 during the firing stroke. Firing member 20841 and sled 20862 move along a longitudinal path within staple cartridge 20800 during a firing stroke to lift driver 20820 along the transverse axis.

Triple driver 20820 is lifted by a single threaded rail 20862 on each side of staple cartridge 20800. Each triple driver 20820 includes an angled recess 20818 (FIG. 102) positioned and dimensioned to receive a sled rail 20862. Stated another way, the sled 20860 has a single rail 20862 on each side of the central portion, and the single rail 20872 is configured to lift and drive the triple driver 20820. In practice, a single rail 20862 is configured to fire all the staples on one side of the staple cartridge 20800 and fires all the staples in three rows (e.g., inner row, middle row, outer row) through triple drivers 20820. ) is configured to fire the staples over the area. Referring primarily to FIG. 102, triple driver 20820 includes an angled recess 20818 (FIG. 102) that is dimensioned to receive sled rail 20862. The angled recess 20818 extends along the central portion of the triple driver 20820 (eg, below the middle/center post), as further described herein.

Triple driver 20820 may be similar to triple driver 20120 (FIG. 26) in many aspects. For example, triple driver 20820 is configured to support three staples 20890 (FIGS. 100B and 101) and lift three staples 20890 simultaneously. The triple driver 20820 also has three struts: an inner strut 20822a configured to support inner staples 20890 in the inner row of staples and an intermediate staple 20890 in the middle row of staples. It also includes an intermediate strut 20822b laterally outward of the inner strut 20822a, and an outer strut 20822b laterally outward of the intermediate strut 20822b and configured to support an outer staple 20890 in the outer row of staples.

Triple driver 20820 also includes a bridge 20826 extending between adjacent struts 20822. For example, first bridge 20826a extends between inner strut 20822a and intermediate strut 20822b, and second bridge 20826b extends between intermediate strut 20822b and outer strut 20822c. A slanted recess 20818 is aligned with the drive rail 20866 and positioned between the first bridge 20826a and the second bridge 20826b and proximal to the intermediate post 20822b.

More specifically, the angled recess 20818 is longitudinally aligned with the intermediate post 20822b. As a result, the intermediate post 20822b of the driver 28020 is disposed within a parallel longitudinal slot 20803 through the cartridge body 20802 and is not supported by, or at least not supported by, the cartridge body 20802 when in the unfired position within the cartridge body 20802. Not supported along the lower part. In such a case, the staples 20890 in the intermediate row of staples on each side of the cartridge body are supported by the intermediate struts 20822b and largely guided by the tissue support deck 20804 of the cartridge body 20802. In certain cases, pocket extensions and/or ridges along the tissue support deck 20804 can further guide the staples 20890 during the firing stroke.

Triple driver 20820 may be symmetrical about a longitudinal axis along angled recess 20818. In various cases, the triple driver 20820 can include wings 20824 that extend laterally outwardly on either side of the intermediate strut 20822b. Wings 20824 are configured to prevent driver roll and strengthen intermediate struts 20822b in certain examples. For example, the wings 20824 can help balance the intermediate strut 20822b during the firing stroke when the intermediate strut 20822b is not supported or largely unsupported by the cartridge body 20802.

Referring primarily to FIG. 103, wings 20824 extend into complementary grooves 20805 within cartridge body 20802. During the firing stroke, wings 20824 move upwardly within grooves 20805 toward tissue support deck 20804. Referring primarily to FIG. 104, grooves 20805 are located on either side of the intermediate staple cavity and extend from the underside of cartridge body 20802 to tissue support deck 20804. In certain cases, the tissue support deck 20804 can capture, prevent, and/or stop further upward movement of the wings 20824 to retain the driver 20820 within the cartridge body 20800 upon completion of the firing stroke. .

Still referring to FIG. 103, the distal portion of intermediate strut 20822b is further configured to nest within a portion of adjacent triple driver 20820. More specifically, the triple driver 20820 includes a proximal groove 20817 (FIG. 102), which is dimensioned to receive the distal tip of an adjacent (e.g., immediately posterior/proximal) triple driver 20820. It is. The nested configuration of triple drivers 20820 arranged end-to-end has a nesting mechanism therebetween to further facilitate alignment and cooperative support of triple drivers 20820 within cartridge body 20802. configured.

In short, the staple cartridge 20800 may include a triple driver 20820 configured to be lifted by a single threaded rail 20866 that pushes against the center portion of the triple driver 20820 and the angled recess 20818 during the firing stroke. The triple driver 20820 can further include wings 20824 on each side, which prevents the triple driver 20820 from rolling during the firing stroke. Wings 20824 are movable within corresponding slots within cartridge body 20802. In certain cases, sled 20860 may be integrally formed with firing member 20841 (eg, an I-beam or E-beam). In such a case, the sled 20860 may be a reusable component along with the firing member 20842, however, an unused knife 20830 may be provided with each staple cartridge 20800. In other cases, the thread can be a separate component within the staple cartridge, and in certain cases, firing member 20841 can include an integral cutting edge.

In various cases, as described herein, a firing member with a triple driver and an integral two-rail thread allows the triple driver to be narrower, thus reducing the cartridge body for rotational drive screws. Can allow more space inside. For example, the rotary drive screw may be located further up in the end effector closer to the upper cam of the firing member rather than along the bottom of the end effector. A narrower driver may, for example, provide a narrower staple line, which may also improve hemostasis in certain cases. Additionally, the inner row of staples can be moved laterally outward to accommodate the rotational drive screw, which can reduce the likelihood and/or incidence of staple tearing. Further, the cartridge body can provide a robust design without narrower struts, towers, and/or thin sidewalls between the staple cavity and/or longitudinal slot for the firing member. The threaded rails can also be made wider in certain instances, thus making them less likely to flex under substantial firing loads. In certain instances, staple overdrive may be minimized when thread rail bending and deflection is limited.

Referring primarily to FIG. 106, the staple cartridge 20800 includes a robust support wall to withstand clamp loads, and the tissue support deck 20804 has a thickness t1 along the inner edge of the intermediate staple cavity and a thickness t1 along the inner edge of the intermediate staple cavity. and a thickness t2 along the outer edge of. Conversely, referring now to a staple cartridge 20900 having a cartridge body 20802 and a tissue support deck 20904, the support walls of the cartridge body 20902 can be narrower than the walls within the cartridge body 20902. Additionally, tissue support deck 20904 has a thickness t3 that is less than thickness t1 and thickness t2 of tissue support deck 20804. Cartridge body 20902 is adapted to receive a 4-rail sled, for example.

Performing a firing stroke while the staple cartridge is missing from the surgical end effector may result in the knife cutting the clamped tissue without any means to seal the cut. Without staples, such as staples, for example, stapling devices cannot staple and seal cut tissue. Similarly, if an empty or used staple cartridge is loaded into the end effector, i.e., a staple cartridge without staples or without a complete set of staples, tissue will also be present along the resection. It is not completely sealed. A lost cartridge lockout can prevent the firing stroke when a staple cartridge is missing from the end effector, and a spent cartridge lockout can prevent the firing stroke when a used staple cartridge is loaded into the end effector. can be prevented. In certain cases, the lockout can prevent the firing stroke when the staple cartridge is lost and used. If a rotary firing screw extends through the end effector, the lockout may be configured to limit and/or prevent rotation of the rotary firing screw, thus preventing a firing stroke.

In one aspect, a lock nut can be placed on the rotational drive screw and a lockout key can be incorporated into a movable mechanism within the staple cartridge. In the locked configuration, the lock nut rotates out of firing alignment and into a lockout notch in the end effector. When an unfired staple cartridge is installed within the end effector, the lockout key engages the locknut and rotates it into firing position and out of the lockout notch. The lock nut moves distally along the rotary drive screw during the firing stroke, and the lockout key is also pushed distally during the firing stroke. The lockout key can remain in a distal position upon completion of the firing stroke and/or retraction of the firing member, however, the locknut can return to a proximal position within the end effector. Since the staple cartridge has been fired (e.g., spent), the lock nut is rotated again from firing alignment into the lockout notch until a replacement unfired staple cartridge is installed in the end effector. Prevents subsequent firing strokes. In other cases, the lock on the rotary drive screw may not be threadably engaged with the rotary drive screw, and the spring locks into the lockout notch to selectively prevent the firing stroke. can be energized.

Such a lockout configuration may be configured to prevent a firing stroke when a staple cartridge is missing and/or when a staple cartridge within the end effector is spent/fired. Furthermore, these configurations can occupy a minimal amount of space within the end effector. Furthermore, the components can be simple and robust. In the example of a lock nut threadably coupled to a rotational drive screw, only a single additional component in the end effector is required for the lockout configuration. In various cases, the lockout key can provide a visual indication to the clinician that the staple cartridge has been fired.

108-115, lockout configuration 21868 and its various components are shown. Lockout configuration 21868 is incorporated into surgical end effector 21840, which is similar in many aspects to surgical end effector 20840 (see FIG. 99). Furthermore, end effector 21840 is adapted to receive staple cartridge 20800 (see FIG. 103). End effector 21840 includes a cartridge jaw 21850 similar to cartridge jaw 20850 (see FIG. 99), however, cartridge jaw 21850 further includes a lockout notch 21854 defined on the bottom side 21856.

More specifically, cartridge jaw 21850 includes a bottom side 21856 and sidewalls 21852 that define a channel dimensioned and structured to receive staple cartridge 20800 therein. Lockout notch 21854 includes a lateral recess or opening in a proximal portion of bottom side 21856. Lockout notch 21854 is aligned with lockout nut 21874 threadably coupled to rotary drive screw 20842 when rotary drive screw 20842 and lockout nut 21874 thereon are in an unfired or proximal position. Ru.

Lock nut 21870 includes a central threaded hole through the body portion, opposing flanges 21874, and lugs 21872. A flange 21874 and a lug 21872 extend radially outwardly from the body portion. In the unlocked position (FIGS. 109B and 111), the flange 21874 extends laterally outwardly to the inner surface of the bottom side 21856 of the cartridge channel 21850 and is positioned to ride along and/or adjacent the inner surface. be done. Further, in the unlocked position, lug 21872 is aligned with upright body portion 20843 of firing member 20841. In the locked position (see FIGS. 108, 109A, 115), the flanges 21874 are rotated out of alignment with the inner surface of the bottom side 21856 such that one of the flanges 21874 rotates into the lockout notch 21854. Ru. Further, in the locked position, lug 21872 rotates out of firing alignment with upright body portion 20843 of firing member 20841.

Lock nut 21870 is threadably coupled to rotational drive screw 20842. Rotation of rotational drive screw 20842 may cause locknut 21870 to rotate therewith, unless rotation of locknut 21870 is prevented or inhibited. Initially, when end effector 21840 does not have a staple cartridge therein (FIGS. 108 and 109A), rotation of rotary drive screw 20842 causes one of flanges 21874 to fall within lockout notch 21854 aligned therewith. The lock nut 21870 is configured to be rotated such that the lock nut 21870 is rotated. When the unused staple cartridge 20800 is installed into the surgical end effector 21840, the lockout nut 21854 is rotated to the unlocked position. The unlocked position of the lockout nut 21854 is shown in FIG. 109B, however, the staple cartridge is hidden for illustrative purposes.

111 and 112, lockout key 20828 includes a foot 20827 that extends into a space within cartridge body 20802 above rotational drive screw 20842. When the unfired staple cartridge 20800 is installed into the end effector 21840, the foot 20827 of the lockout key 20828 rotates the lockout nut 21870 to the unlocked position. More specifically, foot portion 20827 includes an angled surface configured to engage and abut lug 21872 to bias and rotate lug 21872 into alignment with upright body portion 20843. Referring primarily to FIG. 112, cartridge body 20802 includes a detent 20809 extending toward a longitudinal slot 20808 within cartridge body 20802. Detent 20809 is configured to hold lockout key 20828 in place during insertion of staple cartridge 20800 into end effector 21840.

Lockout key 20828 also defines a contour profile 20829 that corresponds to contour track 20807 within cartridge body 20802 . Contoured track 20807 is configured to resist rotation of lockout key 20828 when lockout key 20828 is pushed distally. In various cases, feet 20827 form corners in which lugs 21872 are received. Foot 20827 rotates lug 20872 to the unlocked position. Thereafter, during the firing stroke, lug 21872 can remain engaged with a corner within lockout key 20828 and push lockout key 20828 distally through contoured track 20807. The firing force may be sufficient to overcome the detent 20809 that holds the foot 20827 in a proximal position of the cartridge body 20802.

Additionally or alternatively, knife 20830 can push lockout key 20828 distally through cartridge body 20802. Knife 20830 also includes a contoured contour that is configured to move through contoured contour track 20807 without rotating out of firing alignment during a firing stroke.

Referring now to FIGS. 113 and 114, upon completion of the firing stroke, lockout key 20828 may be pushed to a distal position within cartridge body 20802. In the distal position, lockout key 20828 is visible through window 20806 in cartridge body 20802. For example, the distal nose of the cartridge body 20802 can include a window 20806, and the lockout key 20828 can be placed near the window 20806 such that the lockout key 20828 is visible. Foot 20827 of lockout key 20828 prevents lockout key 20828 from falling out of cartridge body 20802 through window 20808.

Counter-rotational movement of rotary drive screw 20842 is configured to retract firing member 20841. As further described herein, knife 20830 may be retracted with firing member 20841 in various instances. However, lockout key 21828 can be released from knife 20830 and remain in a distal position within cartridge body 20802. Referring primarily to FIG. 115, as firing member 20841 is retracted back to a proximal position within cartridge body 20802, lockout nut 21870 is also retracted proximally along rotary drive screw 20842. Due to the direction of rotation of the rotational drive screw 20840 during the retraction movement, the lockout nut 21870 does not rotate into the lockout notch 21854. Stated another way, lockout nut 21870 remains in the unlocked position and can move proximally past lockout notch 21854 during retraction movement. However, if another firing motion is initiated and the direction of rotation of rotary drive screw 20842 is reversed, lockout nut 21870 will move out of alignment with firing member 20841 when moving distally within end effector 21840. and rotated again, the flange 21874 of the lockout nut 21870 can be rotated into the lockout notch 21854.

In the locked position, lockout nut 21870 cannot rotate relative to rotational drive screw 20842 and cannot longitudinally translate through end effector 21840. As a result, rotational movement of rotary drive screw 20842 is resisted and firing stroke is prevented until lockout nut 21870 assumes the unlocked position.

The lockout arrangement 21868 described herein with respect to FIGS. 108-115 includes a threaded lockout nut 21870 coupled to a rotational drive screw 20842. The displacement of threaded lockout nut 21870 is a function of rotation of rotary drive screw 20840. In other examples, the lockout configuration can include a non-threaded lock disposed around the rotational drive screw 20842. 116 and 117, lockout mechanism 22868 and its various components are shown. Lockout configuration 22868 is incorporated into surgical end effector 22840, which is similar in many aspects to surgical end effector 20840 (see FIG. 99). End effector 22840 is adapted to receive staple cartridge 20800 (see FIG. 103). End effector 22840 includes a cartridge jaw 22850 similar to cartridge jaw 20850 (see FIG. 99), however, cartridge jaw 22850 further includes a lockout notch 22854 defined on bottom side 21856. Additionally, end effector 22840 includes a firing member 22841 that is similar in many aspects to firing member 20841. However, integral sled 20860 of firing member 22841 includes a sled rail 22868 having a hole 22868 therein, as described further herein.

Lockout configuration 22868 includes a lock 22870 that is similar in many aspects to lockout nut 21870, however, lock 22870 is not threadably coupled to rotational drive screw 20842. Lock 22870 includes a central unthreaded hole through a body portion, opposing flanges 22874, and lugs 22872. A flange 22874 and a lug 22872 extend radially outwardly from the body portion.

In the unlocked position, the flange 22874 extends laterally outward to the inner surface of the bottom side 22856 of the cartridge channel 22850 and is positioned to ride along and/or adjacent the inner surface. Flange 22874 is received in hole 22868 of thread 22860. For example, hole 22868 is a through hole in threaded rail 20866 that is sized and positioned to receive opposing flange 22874 when lock 22870 is in the unlocked position. As a result, firing member 22841 and its threaded rail 22868 are configured to pull lock 22870 along rotary drive screw 20842 during a firing stroke. Further, in the unlocked position, lug 22872 is aligned with the upright body portion of firing member 22841.

In the locked position (FIGS. 116 and 117), the flanges 22874 are rotated out of alignment with the inner surface of the bottom side 22856 such that one of the flanges 22874 rotates into the lockout notch 22854. Additionally, in the locked position, lug 22872 is rotated out of firing alignment with the upright body portion of firing member 22841.

Lockout arrangement 22868 also includes a spring 22870 configured to bias lock 22870 into lockout notch 22854. Lockout configuration 22868 can function similarly to lockout configuration 21868, however, when an unfired staple cartridge 20800 is loaded into end effector 22840 and its lockout key 21828 is held in lockout configuration 22868 until completion of the firing stroke. Spring 22870 can bias lock 22870 into lockout notch 22854 such that lockout configuration 22868 is always locked unless the lockout notch 22854 is temporarily overcome. As described above with respect to lockout mechanism 21868, lockout key 21828 moves through window 20806 in cartridge body 20802 upon completion of a firing stroke to ensure completion of the firing stroke and that the staple cartridge has been fired/used. is configured to transmit.

The height of the staples formed is a function of the space between the staple support surface and the staple forming surface. More specifically, the vertical space between (A) the staple support cradle on the driver in the firing position and (B) the staple forming pocket surface in the anvil in the clamping position is the height at which the staple is formed. control. For example, different formed staple heights are selected for different surgical procedures and/or different tissue types. If the staple cartridge includes a rotating firing screw therethrough, the arrangement of the staples and corresponding staple cavities and drivers may be modified to accommodate the rotating firing screw. For example, the driver can include at least one asymmetry, as described further herein. Additionally or alternatively, the driver may be narrower and therefore require additional support and/or strength. Additionally, in various cases it is desirable to optimize tissue spacing while maintaining a desired formed staple height. For example, tissue clearance between the tissue support deck surface and the anvil may be maximized when the end effector is in the closed configuration while maintaining a desired formed staple height.

In various examples, the lower surface of the tissue support deck is configured to receive one or more portions of the driver when the driver is in a fully fired position and/or an overdriven position. , may include contoured and/or grooved surfaces. Interlocking and/or nesting between the lower surface of the tissue support deck and the tissue-facing side of the driver can maximize tissue clearance while still maintaining a desired formed staple height. Furthermore, the interlock mechanism can improve the strength of the driver in various cases.

In one example, the staple cartridge can include a body including a tissue support deck, the staple cavity being defined through the tissue support deck within the body, and the tissue support deck including a textured or raised surface. Including sides. The tissue support deck further includes a lower surface opposite the tissue-facing side, the lower surface including a grooved surface. A staple is removably disposed within the staple cavity. The driver may be configured to movably support the staples and move through a portion of the staple cavity to a firing position to fire the staples from the staple cavity. Each driver can include a base housed within the staple cartridge, the base configured to mate with a grooved surface on the underside of the tissue support deck when moved to a firing position. Contains surface contours.

Referring now to FIGS. 38-40, staple cartridge 22100 is shown. Staple cartridge 22100 is similar to staple cartridge 20100 (FIG. 24) in many aspects. For example, staple cartridge 22100 includes a body 22102 that extends along longitudinal axis A. The staples are removably disposed within the body 22102. Staples may be ejected from the body 22102 and fired into tissue, for example, during a firing stroke. The staples are arranged in longitudinal rows on either side of longitudinal axis A, which is aligned with rotational drive shaft 22242 (FIG. 39) extending therethrough. Cartridge body 22102 also includes a deck 22104, which may be referred to as a tissue support deck, for example. Deck 22104 is a laterally curved tissue support deck that defines a curved tissue-facing surface from a first lateral side 22101 of body 22102 to a second lateral side 22103 of body 22102. A peak 22105 of the laterally curved tissue support deck 22104 is defined in the middle portion of the body 22102. Peaks 22105 can be positioned between longitudinal rows of staples and cover longitudinal axis A, for example. In various cases, rotary firing screw 22242 (FIG. 39) extends through a portion of staple cartridge 22100.

Cartridge body 22102 also includes an array of pocket extensions or ridges 22114 extending from tissue support deck 22104. The ridges 22114 extend around a perimeter or opening formed in the tissue support deck 22104 for the staple cavity. The ridges 22114 may be configured to grip and engage tissue disposed between the staple cartridge 22100 and the opposing anvil. In various cases, the ridges 22114 can restrict and/or inhibit tissue flow, for example. Additionally or alternatively, the ridges 22114 guide the staple legs as they enter tissue and are oriented to engage respective molded pockets on the staple forming surface of the anvil. may be configured to do so. The ridges 22114 may extend around the proximal and distal ends of the staple cavity, for example. Proximally and distally disposed protrusions or pocket extensions allow the outwardly biased staple legs (e.g., of a V-shaped staple) to flare outwardly into a shaped pocket aligned therewith. It is possible to prevent the target position from being lost.

In certain aspects, adjacent ridges 22114 can be connected. For example, the ridges 22114 can be interconnected to longitudinally offset staple cavities and/or laterally offset staple cavities.

In various cases, the array of laterally offset ridges 22114 can define different heights. In various cases, the ridges 22114 may define different heights laterally along the width of the cartridge body 22102. The different heights may, for example, result in lateral curvature of the tissue support deck 22104 and/or different lengths for guiding the staples past the tissue support deck 22104 and/or different tissue curvatures when the end effector is clamped. It can accommodate gaps. With respect to the cartridge body 22102, the ridges 22114 span three laterally spaced rows of staple cavities 22112a, 22112b, 22112c, with the ridges 22114 aligned with the outer row 22112c being taller than the inner rows 22112a, 22112b. , thus guiding the staple legs over a longer distance. However, the tissue gap is also greater across the outer row 22112c than the inner rows 22112a, 22112b due to the lateral curvature of the tissue support deck 22104 and the non-stepped/uncontoured tissue clamping surface of the anvil.

The staples are disposed within a cavity defined within cartridge body 22102, similar to cavity 20110 (FIG. 24). For example, the staples are arranged in longitudinal rows 22112 on either side of longitudinal axis A. Cavity rows 22112 include, on each side of longitudinal axis A, an inner row 22112a, a middle row 22112b, and an outer row 22112c. The middle row 22112b may be equidistantly spaced between the inner row 22112a and the outer row 22112c. A rotary drive screw 22242 can be aligned with longitudinal axis A and can extend through cartridge body 22102 adjacent inner cavity row 22112a. The rotational drive screw 22242 may be between the inner cavity rows 22112a and parallel to the inner cavity row 212a, for example.

Inner row 22112a holds inner staples, middle row 22112b holds middle staples, and outer row 22112c holds outer staples. In various cases, the inner staple, intermediate staple, and outer staple can be the same. In other examples, the inner staple, intermediate staple, and/or outer staple may each differ, for example, with respect to staple type (eg, wire or stamp), material, and/or size (eg, different heights).

In other examples, staple cartridge 22100 may have a different arrangement of staples. For example, staple cartridge 22100 may have less than three rows of staples on each side of longitudinal axis A. In one aspect of the present disclosure, staple cartridge 22100 may have only two rows of staples on each side of longitudinal axis A. In still other cases, staple cartridge 22100 may include four or more rows of staples on one or more sides of longitudinal axis A. In various examples, the rows of staples may be asymmetrical with respect to longitudinal axis A. For example, a first side of staple cartridge 22100 may have a different number of staple rows than a second side of staple cartridge 22100.

Each staple cavity within cartridge body 22102 may include a proximal end, a distal end, and a lateral guide surface intermediate the proximal and distal ends. The staple cavity is constructed and dimensioned to guide the driver 22120 toward the deck 22104 through the staple cavity. Referring primarily to FIG. 41, driver 22120 is shown. Further, in FIGS. 41 and 42, one driver 22120 is shown within staple cartridge 22100. Although one driver 22120 is shown in these figures, the reader should understand that additional drivers, such as driver 22120, may be incorporated into staple cartridge 22100 to fire staples from additional staple cavities during the firing stroke. will understand.

The shape of the staple cavity can complement the shape of the driver 22120. For example, the lateral guide surfaces within each staple cavity are configured to guide sidewalls 22134 of driver 22120 as driver 22120 moves through the staple cavity. Additionally or alternatively, the proximal and/or distal ends of each staple cavity include an upright groove configured to slidably receive the end of the driver 22120 and/or the tongue thereof. may include. Alternative tongue and groove configurations are also contemplated that may be configured to guide driver 22120 through the staple cavity during firing of staples from staple cartridge 22100.

Driver 22120 is configured to support and drive a plurality of staples from cartridge body 22102 during a firing stroke. Driver 22120 can movably support staples spanning two or more longitudinal rows 22112. For example, driver 22120 can movably support inner staples, intermediate staples, and outer staples on the same side of staple cartridge 22100.

Driver 22120 is a triple driver configured to drive three staples simultaneously. The driver 22120 includes three struts: an inner strut 22122a configured to support the inner staples in the inner row of staples; and an inner strut 22122a configured to support the intermediate staples in the middle row of staples. an intermediate strut 22122b laterally outward of intermediate strut 22122a; and an outer strut 22122c laterally outward of intermediate strut 22122b and configured to support an outer staple in the outer row of staples.

Driver 22120 also includes a bridge 22126 extending between adjacent posts 22122. For example, a first bridge 22126a extends between an inner strut 22122a and an intermediate strut 22122b, and a second bridge 22126b extends between an intermediate strut 22122b and an outer strut 22122c. Bridges 22126a, 22126b each include an angled lower surface 22128 configured to be drivingly engaged by the sled during the firing stroke. For example, sled 22150 (FIG. 39) may be configured to move along a firing path during a firing stroke. The sled 22150 has a central portion aligned with the longitudinal axis A, a first rail configured to drivingly engage the sloped lower surface 22128 of the first bridge 22126a, and a sloped bottom surface 22128 of the second bridge 22126b. and a second rail configured to drively engage the lower surface 22128. The sled and its firing motion are further described herein.

Referring primarily to FIGS. 38 and 39, the tissue support deck 22104 includes a tissue-facing side 22115 having an array of ridges 22114 that form a textured tissue grasping surface. Tissue support surface 22104 also includes a lower surface 22116 opposite tissue-facing side 22115. Lower surface 22116 includes a grooved surface having an array of grooves 22118 therein. Grooves 22118 can define a pattern of recesses and/or depressions in lower surface 22116. Tissue support deck 22104 defines a deck height between a textured tissue-facing side 22115 and a grooved lower surface 22116. The deck height varies, however, a certain minimum height around the opening in the deck 22104 provides a minimum amount of guide length for the staple during the firing stroke. For example, if the deck is too thin around the staple cavity, the staples may not be adequately supported during deployment into tissue and toward the molded pocket.

The driver 22120 is configured to mate or nest with the grooved lower surface 22116 when the driver 22120 is moved to the firing position. Referring primarily to FIG. 41 again, the bridges 22126a, 22126b of the driver 22120 include protrusions 22130. The protrusions 22130 are surface contours and protrusions on the upper tissue-facing surface of the bridges 22126a, 22126b opposite the sloped lower surface 22128 of the bridges 22126a, 22126b. Protrusions 22130 are configured to be received within grooves 22118 on the lower surface 22116 of tissue support deck 22104 when drivers 22120 are moved to their firing position. In the firing position, and referring primarily to FIG. 40, driver 22120 is overdriven relative to deck 22104 such that a portion of driver 22120 extends out of cartridge body 22102 beyond tissue-facing side 22115.

The top surfaces of bridges 22126a and 22126b are symmetrical about the longitudinal centerline of each bridge 22126a, 22126b. The centerline of each bridge 22126a, 22126b may be equidistant between the longitudinal axes defined by the staple support cradles 22124 of adjacent struts 22122. The protrusions 22130 are symmetrical about the longitudinal centerline of the respective bridges 22126a, 22126b.

In other examples, the driver, its bridge, and/or its top surface may be laterally asymmetric, as described further herein. Referring to driver 22220 of FIG. 42, driver 22200 is similar in many aspects to driver 22120 (FIG. 41), however, driver 22200 is similar to driver 22220 (FIG. 41); to define a lateral asymmetry. Driver 22220 includes three posts 22222a, 22222b, 22222c each having a staple support cradle 22224. Bridges 22226a, 22226b connect laterally adjacent struts 22222a, 22222b, 22222c. The bridges 22226a, 22226b include an angled lower surface 22228 that is driven by the sled during the firing stroke, as further described herein. The top surface 22230 of the bridges 22226a, 22226b includes a diagonal surface and is asymmetrical about a centerline through the bridges 22226a, 22226b and is aligned with the firing path of the sled rail during the firing stroke. The centerline of each bridge 22226a, 22226b is equidistant between the axes aligned with adjacent staple support cradles 22224 and staple bases/crowns therein.

The upper surface 22230 of each bridge 22226a, 22226b includes a laterally sloped upper surface that is part of a contoured lower surface of the tissue support deck, such as a grooved lower surface 22116 (FIGS. 39 and 40). is configured to complement the Such a bridge configuration may provide improved inter-row support that may allow the entire bridges 22226a, 22226b to be thinner while providing sufficient support for staples across multiple rows.

An anvil 22370 for a surgical end effector is shown in FIG. Anvil 22370 includes a tissue compression surface 22374 and a pair of staple forming pockets 22372 formed within tissue compression surface 22374. Each pair of staple forming pockets 22372 includes a proximal pocket 22372a and a distal pocket 22372b. The pocket may be aligned with a leg of the staple, such as a wire leg of the staple. During the firing stroke, the tips of the staple legs may be received within staple forming pockets 22372 and formed into, for example, a B-shaped staple. In certain aspects of the present disclosure, the length of staple forming pocket 22372 may be configured to match the wire diameter of the staple aligned therewith. For example, proximal pocket 22372a and distal pocket 22372b in a first pair of staple forming pockets 22372 in anvil 22370 can have a first pocket length, while a second pair of staple forming pockets in anvil 22370 Proximal pocket 22372a and distal pocket 22372b within molded pocket 22372 can have different pocket lengths. The first pocket length can correspond to a different staple wire diameter than the second pocket length. In various embodiments, larger wire diameter staples can accommodate shorter pocket lengths.

The space d between the proximal pocket 22372a and the distal pocket 22372b in the pair of staple forming pockets 22372 may be minimized in certain instances to maximize the longitudinal forming length of the staple. Generally, staples are over-bent during the forming process to compensate for staple bounce. However, staple overbending can be reduced when the forming pockets are shorter and therefore, in some cases, steeper. A shorter, steeper staple pocket that defines a larger space or gap d between the proximal pocket 22372a and the distal pocket 22372b in the pair of staple forming pockets 22372 can reduce bounce. A shorter, steeper staple pocket can cause the staple legs to curve more and cause the staple to deform more plastically, for example, to reduce bounce. Additionally, shorter, steeper staple pockets can improve continuous staple leg flexion in certain cases. Referring to space d in FIG. 43, the proximal pocket 22372a and distal pocket 22372b in the pair of staple forming pockets 22372 can be shortened, and the entire pair has a larger space d in the proximal pocket 22372a and distal pocket 22372b. The same length L can be maintained as defined between 22372b and 22372b.

For example, in an end effector, the staples and/or drivers may be different from row to row. In certain examples, the staples may be shorter, include different wire diameters, and be lifted by drivers having different heights and/or different amounts of overdrive. In certain instances, shorter staple forming pockets may be utilized with one row of staples and not with an adjacent row of staples within the same anvil, as described above. For example, shorter staples utilize shortened pockets to improve successive staple leg bends, e.g., two successive bends on each staple leg, resulting in a B-shape. be able to. In yet other examples, the staples along the inner row of staples, i.e., adjacent to the longitudinal knife path, are shortened to more plastically bend the staples and reduce bounce to form a narrower row. You can use the pockets provided. In these examples, the distance d in Figure 43 may vary from column to column.

Staple cartridges, such as staple cartridge 20100 (FIG. 24) and staple cartridge 22100 (FIG. 39), may, for example, have minimum size limitations to ensure that adequate strength, stiffness, support, and/or manufacturing requirements are met. Contains components that have. These minimum size limitations can make it difficult to optimize and/or increase tissue spacing given other constraints on the surgical end effector. As an example, the minimum height of the tissue support deck is 0.01 inch in some cases due to molding constraints. As another example, the minimum height of the bridge between posts on the driver is 0.022 inches in some cases due to driver strength constraints. As another example, the minimum height of a driver (eg, its post) is 0.066 inches in one case due to driver driver roll constraints. As another example, the minimum height of the staple leg may be 0.166 inches in certain instances, 0.160 inches in other instances, and 0.150 inches in other instances based on the type of staple cartridge and target tissue. inches, in other examples 0.102 inches, and in other examples 0.085 inches. As another example, the minimum thickness of the anvil is 0.134 inches, and in a particular example, 0.154 inches due to anvil stiffness and strength constraints. In view of such minimum size constraints, it may be advantageous in certain cases to reduce the minimum size limit and/or to double count certain size limits, or portions thereof, in the stackup of components. could be.

For example, a portion of the driver may be nested in a recess in the underside of the tissue support deck in certain instances to reduce certain minimum size limitations. In various cases, recesses may be added to tissue support decks of increased height, such as under pocket extensions/tissue grasping ridges, to ensure that the tissue support deck maintains the appropriate height. can be aligned with local regions along the In other examples, one or more additional recesses in the lower surface of the tissue support deck may be configured to receive a portion of the driver and/or its bridge. An exemplary staggered arrangement of interlocking mechanisms between the interior surface of the staple cartridge and the driver is shown, for example, in FIG. 39. Other driver mechanisms may similarly be received within corresponding recesses in the underside of the tissue support deck.

To reduce vertical stacking dimensions of multiple components, the tissue support decks of staple cartridges, such as staple cartridge 20100 (FIG. 24) and staple cartridge 22100 (FIG. 39), are separate and distinct from the staple cavities. may have a predetermined clearance hole through it. A predetermined hole along the length and/or width of the staple cartridge receives a driver mechanism (e.g., a portion of the bridge) in a fully fired position of the driver, and in various instances an overdriven position. be able to. Additionally or alternatively, the tissue support deck can include a frangible or "destroy site" that is configured to be physically destroyed by the driver once the driver moves to the fully fired position. .

In addition, staple cartridges such as staple cartridge 20100 (FIG. 24) and staple cartridge 22100 (FIG. 39) may further include selectively compressible and expandable features, for example, to reduce vertical stack-up dimensions. may be included. The driver and/or cartridge body can include such features.

For example, a vertically expandable driver can be configured to reduce the rest or unfired height of the driver within the staple cartridge. The driver may be telescoping and may define a height that is approximately 50% of its final height when in the unfired position. In such cases, the staple may be lower within the cartridge body prior to firing. In some cases, the first portion of the threaded rail can overcome any significant snapping mechanism with the body of the driver and actuate the driver by expanding it to its final height. The second portion of the thread rail can then complete firing of the driver to eject the staples supported thereon from the cartridge body. The first portion of the threaded rail can be narrower than the second portion of the threaded rail.

Additionally or alternatively, the tissue support deck can include a variable height injection molded deck that can be compressed to increase the tissue gap when a predetermined tissue load is applied. When the sled fires the driver and staples, the sled and/or driver can locally push the deck back into the tissue to temporarily increase the height to temporarily reduce the tissue gap. The tissue support deck may then relax or otherwise return to a compressed state corresponding to the increased tissue gap after the thread has passed.

For example, the cartridge body or its tissue support deck may include selectively positioned wall segments that may be thin and configured to buckle under a predetermined tissue load, while retaining the staples. Still maintaining proper alignment with the staple forming pocket within the anvil. In some cases, electrically actuated materials (eg, electroactive polymers) can be incorporated into the tissue support deck. A component or feature formed of such a material becomes softer and/or more easily compressible when an electric current is applied to it, and becomes stiffer and/or less easily compressible when no electric current is applied to it. obtain. In certain examples, a portion of the driver may be received within the tissue support deck when the material is energized and thus be deformable to accommodate additional structures therein.

In certain cases, 4D printed materials can facilitate selective folding of tissue support decks of staple cartridges, such as, for example, staple cartridge 20100 (FIG. 24) and staple cartridge 22100 (FIG. 39). For example, the cartridge body can include 4D printed material printed on its top or top half. 4D printed materials can be heat sensitive. In certain cases, the material may have a glass transition temperature between room temperature and the temperature of the human body. For example, when the cartridge is clamped onto tissue, the material can become flexible and deflectable, thus increasing the tissue gap. In such cases, increased heat from the patient can increase the heat of the 4D printed material resulting in a shape change. When the cartridge body is subsequently cooled (eg, removed from thermal transfer contact with tissue), the 4D printed material can return to its original shape and/or height. In the original recovered state, the tissue support deck may be higher than in the heated and convoluted state, for example. The increased height in the original and recovered states can, for example, ensure that staples stored within the staple cartridge remain protected and do not protrude from the cartridge body before being fired.

Referring now to FIG. 44, a deformation and recovery process 22400 for a 4D printed matrix on a cartridge body is shown. During the shape programming stage 22490, the 4D printed matrix 22402 is heated, transformed from the original configuration to the deformed configuration 22402', and then cooled. During the shape recovery state 22492, the 4D printed matrix 22402' is heated, returns to its original configuration 22402, and then cooled. Shape programming and recovery of 4D printed materials is described in the paper “4D Printing Reconfigurable, Deployable and Mechanically Tunable Metadata” in Materials Horizon, Issue 6, 2019 by Chen Yang et al. terials”.

In certain examples, 4D printed matrices can be used in combination with, for example, foldable or collapsible drivers as further described herein. The 4D printed matrix on the staple cartridge may be configured, for example, to selectively collapse the interference driver mechanism to consolidate and/or compress the footprint and stackup within the staple cartridge at a particular temperature. The interference mechanism can then be deployed when the cartridge body is withdrawn from the interference condition, such as when the cartridge body restores its original, undeformed condition. In various embodiments, the driver can be fully expanded when actively lifting and firing the staple. In certain instances, the driver may encounter an interference surface near its fully fired position, and the upper portion of the driver may be configured to fold into itself. The 4D matrix can optionally form an interference surface.

A user may desire to quickly and easily place a staple cartridge into a channel of an end effector or disposable loading unit during a surgical procedure. A strong connection may also be desired. Certain strong connections may require the clinician to overcome significant resistance and/or frictional forces between interfering components. Additionally or alternatively, a strong connection may have minimal clearance and require precise alignment of the components by the clinician. A strong connection between the staple cartridge and the channel may be desired, but also to make installation of the staple cartridge faster, easier, and/or to require less force and/or effort on the part of the clinician. That can be useful.

In certain examples, the stapling assembly can include a levering mechanism that can facilitate installation of the staple cartridge within the channel. For example, the channel and staple cartridge can include complementary geometric alignment features. When the staple cartridge alignment feature is placed relative to the channel alignment feature, the channel alignment feature can provide a fulcrum or abutment surface about which the staple cartridge is centered. , levered to properly align the staple cartridge with the channel. When the staple cartridge is properly aligned by the abutting relationship between the alignment features, additional alignment features (e.g., distal lugs and notches) facilitate further connections between the staple cartridge and the channel. It can be done.

In certain cases, the spring can bias the staple cartridge distally along a longitudinal axis perpendicular to the insertion axis to fully and securely seat the staple cartridge within the channel. Additionally or alternatively, the distal firing force during the firing stroke may cause the staple cartridge to shift further distally so that ramped surfaces on the alignment features (e.g., distal lugs and distal edges of notches) can be interconnected. Alternative spring-loaded and/or resilient mechanisms are contemplated to further secure the staple cartridge to the channel upon proper placement of the staple cartridge relative to the channel. In certain cases, the user-actuated release may be configured to release one or more resilient attachment mechanisms between the staple cartridge and the channel. In other examples, the firing stroke may result in the release and/or destruction of one or more resilient attachment mechanisms.

In one example, a stapling assembly can include a staple cartridge including a cartridge body defining a longitudinal axis, the cartridge body comprising a proximal cartridge alignment feature and a distal cartridge alignment feature. The stapling assembly can further include a channel dimensioned to receive a staple cartridge, the channel having a proximal channel alignment feature and a proximal cartridge alignment feature matching the proximal channel alignment feature. and a distal channel alignment feature arranged to receive the distal cartridge alignment feature when the staple cartridge is disposed in mating engagement and moved along the insertion axis to the first position within the channel. Including side walls. The insertion axis may be perpendicular to the longitudinal axis. The spring may be configured to bias the staple cartridge distally within the channel along the longitudinal axis from the first position to the fully seated position. The proximal alignment feature can include a contoured abutment surface. The distal alignment feature can include a notch and a lug with complementary wedge-shaped distal ends.

In various cases, the improved cartridge retention and release mechanism can increase engagement retention force while allowing a user to release a staple cartridge from a channel with substantially less force. For example, a user can slide the staple cartridge proximally by overcoming minimal spring force to quickly and easily remove the staple cartridge from the channel. In certain cases, the force required to remove a used or fired staple cartridge may be less than the force required to remove a new, unfired staple cartridge. For example, a firing stroke, or even a partial firing stroke, may be configured to disengage and/or release a particular resilient attachment mechanism connecting the staple cartridge to the channel.

Referring now to FIG. 45, stapling assembly 24000 is shown. Stapling assembly 24000 includes a channel 24050 and a staple cartridge 24100 removably disposed within channel 24050. Staple cartridge 24100 is a disposable, single-use component that is configured to be removed from channel 24050 after the firing stroke and surgical procedure with it. Channel 24050 may be reusable and may be configured to receive a replacement staple cartridge assembly therein. In other examples, staple cartridge 24100 may be removed from channel 24050, loaded with additional staples, and reinstalled in channel 24050. Channel 24050 may be a component of a disposable loading unit and/or modular stapling assembly, including an anvil and/or shaft portion, in certain examples.

Staple cartridge 24100 may be similar to staple cartridge 20100 (FIG. 24) in certain aspects. For example, staple cartridge 24100 includes a cartridge body 24102 having a tissue support deck 24104, staples 24160 removably disposed within cartridge body 24102, and a driver 24120 that movably supports staples 24160. Staple 24160 includes an end-to-end base, with the base of staple 24106 oriented obliquely to longitudinal axis A along the length of staple cartridge 24100. Staple 24160 may be configured to form a flexible staple line that allows for some degree of twisting and/or elongation while minimizing damage to tissue. In certain cases, cartridge body 24102 has staples in a plurality of longitudinal rows with staples longitudinally aligned in longitudinal rows parallel to longitudinal axis A, as further described herein. may be included.

Cartridge body 24102 includes at least one alignment nub 24162 having a proximal alignment surface 24164. In various cases, alignment nubs 24162 may project laterally from each side of cartridge body 24102. Proximal alignment surface 24164 defines a curved proximal edge of alignment nub 24162. In various cases, alignment nubs 24162 on opposite sides of cartridge body 24102 may be symmetrical about longitudinal axis A.

Cartridge body 24102 further includes an alignment lug 24166 having a proximal end 24168 and a distal end 24170. One alignment lug 24166 is located on each side of the cartridge body 24102. Proximal end 24168 defines an upright or perpendicular surface relative to tissue support deck 24104. The distal end 24170 of the alignment lug 24166 defines a wedge shape with an angled distal surface. The sloped distal surface can create a narrower dimension along the deck 24104 and a wider dimension at the opposite end of the alignment lug 24166. In various cases, alignment lugs 24166 may be disposed on each side of cartridge body 24102, and alignment lugs 24166 may be symmetrical about longitudinal axis A. Alignment lug 24166 is closer to the distal end of cartridge body 24102 than alignment nub 24162.

Channel 24050 includes lateral sidewalls 24052 forming a U-shaped channel. Staple cartridge 24100 may be releasably secured within the U-shaped channel between sidewalls 24052. Sidewall 24052 and/or other portions of channel 24050 may include resilient snap-fit features for engaging staple cartridge 24100. Each sidewall 24052 includes an alignment feature 24054 that includes a proximal alignment contour 24056. Proximal registration contour 24056 includes an edge configured to capture proximal registration surface 24164 of registration nub 24162. Proximal alignment contour 24056 resists longitudinal displacement of alignment nub 24162 in a proximal direction beyond proximal alignment contour 24056. As further described herein, alignment feature 24054 may function as a fulcrum or support against which staple cartridge 24100 is levered during insertion and installation of staple cartridge 24100 into channel 24050.

Channel 24050 further includes an alignment notch 24058 having a proximal end 24060 and a distal end 24062. Alignment notches 24058 are located on each side of channel 24050. The proximal end 24060 defines an upright or vertical plane in the sidewall 24052 and the distal end 24062 defines another upright plane in the sidewall 24052 that is parallel to the vertical plane at the proximal end 24060. isn't it. The upright surface defining the distal end 24062 of the alignment notch 24058 can define a sloped or sloped distal surface, which has a narrower dimension along the upper edge of the sidewall 24052; A wedge shape with wider dimensions can be formed at the opposite end of notch 24058. In various cases, alignment notches 24058 may be symmetrically positioned about longitudinal axis A. Alignment notch 24058 is closer to the distal end of cartridge body 24102 than alignment nub 24162. As further described herein, each alignment notch 24058 is positioned and dimensioned to receive one of the alignment lugs 24166 therein.

The alignment features between channel 24050 and staple cartridge 24100 are configured to interact to facilitate quick and easy installation of staple cartridge 24100 within channel 24050. For example, to quickly align alignment lug 24166 with alignment notch 24058, the clinician may pull alignment nub 24162 proximally into abutting engagement with corresponding alignment feature 24054 on channel 24050. can be done. Proximal alignment contour 24056 on proximal alignment feature 24054 acts as a longitudinal stop that prevents further proximal displacement of staple cartridge 24100 relative to channel 24050. The contoured proximal edge 24164 of the registration nub 24162 can match or complement the contoured contour of the proximal registration contour 24056. When the complementary contours are mated, each alignment lug 24166 is also aligned with a corresponding alignment notch 24058.

Spring 24172 is disposed between the upright surfaces of alignment lug 24166 and alignment notch 24060. More specifically, spring 24172 is disposed between proximal end 24168 of alignment lug 24166 and proximal end 24060 of alignment notch 24060. Spring 24172 biases beveled distal end 24170 of alignment lug 24166 distally into mating contact with beveled distal end 24062 of channel 24050 when staple cartridge 24100 is inserted into channel 24050. It is configured to allow When alignment nub 24162 abuttingly engages proximal alignment contour 24056 and staple cartridge 24100 and its alignment lug 24166 move into channel 24050 in installation direction 24101 parallel to installation axis I, spring 24172 It may be compressed between the upright proximal end 24060 of the alignment notch 24060 and the upright proximal end 24168 of the lug 24166. The installation axis I is perpendicular to the longitudinal axis A.

In use, cartridge body 24102 and its nub 24162 may be levered against proximal alignment contour 24056 of channel 24050 as staple cartridge 24100 is moved into the channel along deployment axis I. The proximal levering location of alignment contour 24056 can improve the mechanical advantage of installing staple cartridge 24100 and its distal lug 24166 within channel 24050. The nub 24164 may slide downward into the channel 24050 as the staple cartridge 24100 moves in the installation direction 24101 to the first or insertion position. After staple cartridge 24100 is moved to a first position in which staple cartridge 24100 is inserted but not fully seated within channel 24050, spring 24172 moves staple cartridge 24100 distally in a direction parallel to longitudinal axis L. , the staple cartridge 24100 is configured to shift to a second position where it is fully seated within the channel 24050.

Referring primarily to FIG. 47, spring 24172 is a leaf spring. Spring 24172 has a first end attached to alignment lug 24166, a second end opposite the first end, and a spring 24172 with a A cantilevered spring having a curved portion. The curved portion can define an S-shaped curve that aligns the proximal registration contours 24056, 24164 and leverages the staple cartridge 24100 proximally relative to the registration feature 24054. Compressible with minimal force and/or effort by the clinician. When the leverage and compression forces on spring 24172 are released, spring 24172 springs back and biases staple cartridge 24100 distally against channel 24050 into the fully seated position (FIG. 48). It is configured as follows.

In the fully seated position (FIG. 48), the distal sloped ends 24062, 24170 of the alignment lugs 24166 and alignment notches 24058 are in mating engagement, respectively. The undercut shape of the distal ends 24062, 24170 allows the staple cartridge 24100 to be moved proximally along the longitudinal axis A and then parallel to the installation axis I in the installation direction 24101 in order to remove the staple cartridge 24100 from the channel 24050. is configured to secure staple cartridge 24100 within channel 24050 until spring 24172 is compressed by a force applied by the user to pull upward in opposite direction 24103.

In certain cases, the firing element is configured to apply a distal force to the staple cartridge 24100 during the firing stroke to further secure the staple cartridge 24100 within the channel 24050. For example, angled distal ends 24062, 24170 can form an interlock between staple cartridge 24100 and channel 24050 when staple cartridge 24100 is pushed distally. In certain cases, the distal firing force and undercut shape of the angled distal ends 24062, 24170 can secure the staple cartridge 24100 in the channel 24050 without the distal biasing force of the spring 24172. For example, stapling assembly 24000 may not include a spring configured to bias staple cartridge 24100 against channel 24050 in the direction of the firing stroke. The reader will note that in stapling assemblies that utilize a distal-to-proximal firing stroke, for example, an undercut interlock between staple cartridge 24100 and channel 24050 may cause alignment lugs 24166 and alignment notches 24058, respectively. It will be appreciated that the proximal end 24168, 24060 may be present.

47-48, stapling assembly 24000 is shown with anvil 24090 in a clamped configuration against channel 24050 and staple cartridge 24100 fully seated therein. Cartridge body 24102 includes a distal nose 24103 having a lock 24180. Lock 24180 includes a latch arm 24182 on the underside of cartridge body 24102. Latch arm 24182 is configured to overlap a portion of channel 24050 when staple cartridge 24100 is fully seated within channel 24050. For example, channel 24050 includes a ledge or shelf 24082 on its lower surface facing latch arm 24182. The lock 24180 is arranged in a first position (FIG. 49) in which the latch arm 24182 overhangs the shelf 24082 to secure the distal nose 24103 of the cartridge body 24102 to the distal end of the channel 24050; and a second position to facilitate release of the staple cartridge 24100 from the channel 24050.

Lock 24180 also includes a release button 24184 facing the anvil on the opposite side of latch arm 24182. The release button 24184 facing the anvil can be flush or substantially flush with the top surface of the distal nose 24103. A release button 24148 facing the anvil can be depressed by the clinician to drive the lock 24180 downwardly and/or distally to release the latch 24182 from engagement with the shelf 24082. In certain cases, the lock 24180 may be constructed from a resilient and/or deformable material and flexes upon receiving user input on the anvil-facing release button 24184 to move the latch arm 24182 to the second position. be able to. In other examples, lock 24180 can pivot relative to cartridge body 24102 to move latch arm 24812 to the second position.

In other examples, the distal nose of the cartridge body may be deflectable to releasably engage a retention feature along the distal edge of the elongated channel. For example, referring now to FIG. 50, stapling assembly 24200 is shown with anvil 24190 in a clamped configuration relative to channel 24050 and staple cartridge 24300 fully seated therein. Staple cartridge 24300 is identical to staple cartridge 24100, however, distal nose 24301 is constructed of a flexible material or flexible portion forming a lock 24380 with a latch arm that is connected to channel 24050. is configured to flex to engage and disengage the shelf 24082 on the lower surface of the. In certain cases, the entire distal nose 24301 may be flexible to facilitate bending of the latch arm 24382 out of engagement with the ledge 24082. In other examples, only the lock 24380 and/or its latch arm 24382 is flexible enough to disengage the ledge 24082.

In various cases, the cartridge body 24302 can be a composite cartridge body constructed of different materials in different regions such that the flexibility of a single composite cartridge body can vary from region to region. For example, the cartridge body 24302 may be 3D printed with flexible and/or resilient materials for the lock 24380 and/or latch arm 24382 and less flexible and/or resilient materials for adjacent areas within the cartridge body. and a lower elastic material. Additionally or alternatively, in certain examples, the adjacent portions may be printed with a material having the same or similar relatively low durometer as the lock 24380 and/or latch arm 24382, but are not embedded within the cartridge body. Additional metal, such as a metal frame and/or longitudinal support, can increase the overall strength and stiffness of the cartridge body.

Additional alignment and retention mechanisms between the staple cartridge and the channel are envisioned that can improve retention and release of the staple cartridge from the channel. Various features can improve the ease of aligning the components and the force required to remove the staple cartridge from the channel while maintaining sufficient retention between the staple cartridge and the channel. These additional alignment and retention features can be combined with the proximal alignment features between the staple cartridge and the channel described further herein.

In FIG. 51, a surgical stapling assembly 25000 is shown. The stapling assembly 25000 is similar in many aspects to the stapling assembly 24000 and includes a staple cartridge 25100 and a channel 25050; however, the stapling assembly has an alternative Includes proximal alignment and retention features. In addition, staple cartridge 25100 includes a longitudinal row of staple cavities within its cartridge body 25102 and longitudinally aligned staples disposed within the staple cavities. The staple cavity is oriented parallel to the longitudinal axis A that extends along the centerline of the longitudinal slot and cartridge body 25102.

Cartridge body 25102 includes an alignment lug 25166 that includes a proximal end 25168 and a distal end 25170. Alignment lugs 25166 can be located on each side of cartridge body 25102. Proximal end 25168 can define an upright or vertical surface, and distal end 24170 can also include an upright or vertical surface. The upright surfaces defining proximal end 25168 and distal end 25170, respectively, can be parallel or substantially parallel. In various cases, alignment lugs 25166 may be disposed on each side of cartridge body 25102, and alignment lugs 25166 may be symmetrical about a centerline through cartridge body 25102.

Staple cartridge 25100 also includes lateral pins 25180 that project outwardly from cartridge body 25102. Another symmetrically disposed lateral pin 25180 can project laterally outwardly on the other side of the cartridge body 25102.

Channel 25050 includes lateral sidewalls 25052 forming a U-shaped channel. Staple cartridge 25100 may be releasably secured within the U-shaped channel between sidewalls 25052. Channel 25050 further includes an alignment notch 25058 that includes a proximal end 25060 and a distal end 25062. Alignment notches 25058 can be positioned on each side of channel 24050 to receive corresponding alignment lugs 25166. Proximal end 24060 defines an upright or vertical surface within sidewall 24052 and distal end 24062 defines another upright surface within sidewall 24052. The upright surfaces may be parallel or substantially parallel.

In other examples, the distal ends 25062, 25170 of the alignment notches 25058, 25166, respectively, are undercut when the staple cartridge 25100 is fully seated within the channel 25050, as further described herein. Additionally, staple cartridge 25100 can be further secured to channel 25050.

Channel 25050 further includes a slot 25084 that defines an internal track for lateral pin 25180. Slot 25080 includes a V-shaped or tapered inlet portion 25082 that extends parallel to the direction of insertion of staple cartridge 25100 and a distal portion 25084 that extends parallel to the longitudinal axis of the cartridge body. The V-shaped entry portion 25082 provides a wider entry area 25083 for the lateral pin 25180 into the slot 25084, which eliminates the need for the clinician to align the staple cartridge 25100 in the channel 25050 with exacting precision. Ensure that there are no Additionally, the wider entry area 25083 to the slot 25084 provides a greater longitudinal positional tolerance for the staple cartridge 25100 relative to the channel 25050 than the longitudinal positional tolerance for aligning the registration lug 25166 with the entry area 25063 of the registration notch 25058. A larger range of locations may be defined.

The alignment features between channel 25050 and staple cartridge 25100 are configured to interact to facilitate quick and easy installation of staple cartridge 25100 within channel 25050. For example, in order to quickly align the alignment lug 25166 with the alignment notch 25058, the clinician may choose within a wider range of longitudinal positions to place the lateral pin 25180 within the entry portion 25083 of the slot 25080. Staple cartridge 25100 can be placed anywhere. As the transverse pin 25180 moves along the narrowing track of the V-shaped portion 25082 of the slot 25080, the lug 25166 may be funneled into alignment with the alignment notch 25058.

In various cases, staple cartridge 25100 can fall into channel 25050 with minimal interference or frictional resistance. For example, staple cartridge 25100 may not be secured to channel 25050 by a tight friction fit mechanism between staple cartridge 25100 and channel 25050. Alternatively or in addition to such a friction fit mechanism, the shape of slot 25080 can secure staple cartridge 25100 within channel 25050. For example, frictional forces exerted on staple cartridge 25100 during a proximal-to-distal firing stroke may cause lateral pin 25180 to move distally along distal portion 25084 of slot 25080, causing staple cartridge 25100 to move within channel 25050. can be shifted distally. In such a case, the firing force can move the lug(s) 25166 to their most distal position flush with the distal end 25062 of the alignment notch 25058.

In various cases, to remove the used staple cartridge 25100 from the channel 25050, the clinician can pull the staple cartridge 25100 proximally to remove the lateral pin 25180 from the distal portion 25084 of the slot 25080. When the staple cartridge 25100 is shifted proximally by the clinician (which requires minimal force and effort), the clinician can quickly and easily lift the staple cartridge 25100 out of the channel 25050.

An alternative latching mechanism between staple cartridge 26100 and channel 26050 for stapling assembly 26000 is shown in FIGS. 52 and 53. Staple cartridge 26100 is similar in many aspects to various staple cartridges described herein, including a cartridge body 26102 having staples and a staple support driver movably disposed within cartridge body 26102. may include. Channel 26050 includes opposing sidewalls 26052 forming a U-shaped channel profile that are configured to receive staple cartridge 26100 therebetween or at least primarily therebetween. For example, staple cartridge 26100 includes a lateral latch arm 26180 configured to releasably engage a lateral recess 26080 along an outer surface of sidewall 26052.

Latch arm 26180 extends along a lateral side of staple cartridge 26000 and can be integrally formed (eg, molded) with cartridge body 26102. For example, cartridge body 26102 and latch arm 26180 can be a single, unitary component. In various examples, latch arm 26180 can be deflectable. Latch arm 26180 includes a user actuated button 26182 and a catch 26184. Fastener 26184 is longitudinally offset from user actuated button 26182. A lever arm extends between user actuated button 26182 and catch 26184 such that actuation of button 26182 is configured to deflect catch 26184. For example, actuation applied inwardly to the button 26182 is configured to deflect the catch 26184 outwardly and out of engagement with the lateral recess 26080. In certain examples, deflection of the fastener 26184 when the clinician actuates the button 26182 is configured to remove the fastener 26184 from the recess 26080. In other examples, the fastener 26184 can be moved to a less engaged position and thus can more easily overcome its position relative to the recess 26080. The clinician can apply a pinching motion to buttons 26182 to actuate both buttons 26182 simultaneously and deflect both fasteners 26184 out of engagement with recess 26080.

In various cases, to install staple cartridge 26100 within channel 26050, staple cartridge 26100 may be moved vertically in the insertion direction until a portion of cartridge body 26102 rests within channel 26050. In this position, latch arm 26180 may be aligned with longitudinal guides along the outer surface of sidewall 26052. When the cartridge body 26102 is slid proximally into the fully seated position within the channel 26050, the latch arm 26180 moves along the longitudinal guide and the catch 26184 snaps into the recess 26080. , securing staple cartridge 26100 in the fully seated position. When staple cartridge 26100 is fully seated within channel 26050 and fastener 26184 is engaged or locked within recess 26080, the width of the stapling assembly remains within a conventional sized trocar (e.g., 12 mm profile). It is possible. To release the staple cartridge 26100 from the channel 26050, the clinician pinches the button 26182 to force the catch 26184 outwardly from the recess 26080 so that the clinician can release the staple cartridge 26100 from the longitudinal axis. It can be removed by pulling away from channel 26050 distally and/or vertically along A.

In certain examples, cartridge body 26102 is plastic and latch arm 26180 is also plastic. For example, cartridge body 26102 and latch arm 26180 can be molded composite plastic components.

In other examples, the cartridge body may be a composite assembly of plastic and metal. For example, the latch arm may be a metal spring formed with the cartridge body. The latch arm may be an insert molded metal arm. Metal latch arms can provide a greater spring rate and snap latch mechanism than plastic arms in certain instances.

In certain examples, the stapling assembly can include a frangible cartridge retention feature configured to secure the staple cartridge within the channel until intentionally destroyed by a user. has been done. For example, the clinician can intentionally destroy the cartridge retention mechanism and/or the mechanism can destroy during the firing stroke, such as at or near the completion of the firing stroke. Disruption of the frangible cartridge retention mechanism can reduce the retention force between the staple cartridge and the channel, allowing the clinician to remove the staple cartridge with a lower amount of force. In various cases, when the frangible mechanism is ruptured, it may remain connected to the staple cartridge body. For example, referring back to lock 24380 in FIG. 50, the lock can include a weakened portion that is activated when a user applies intentional motion to the staple cartridge to remove the staple cartridge from the channel. It is constructed in such a way that it breaks but does not fall off.

In certain cases, the staple cartridge may include a detent that is engaged with the channel and released from the channel upon completion of the firing stroke. Referring now to FIGS. 54-59, staple cartridge 26200 is shown, which is similar in many aspects to staple cartridge 20100 (FIG. 24). For example, staple cartridge 26200 includes a cartridge body 26202 that includes a tissue support deck 26204 having a staple cavity defined therein, which is similar in many aspects to firing screw 261 (see FIGS. 4 and 5). Arranged in three longitudinal rows 26212a, 26212b, 26212c on each side of one rotational drive screw 26242. The staples within staple cartridge 26200 are supported by driver 26220, which is similar in many aspects to triple driver 20120 (FIG. 26). For example, driver 26220 may include three parallel staple supports configured to support staples such that driver 26220 is configured to simultaneously fire staples from inner row 26212a, middle row 26212b, and outer row 26212c. Including cradle.

Staple cartridge 26200 includes a detent 26280 that releasably engages the channel. Detent 26280 is movable between a locked configuration (FIGS. 54-57) and an unlocked configuration (FIGS. 58 and 59). In certain examples, the inwardly facing side of the channel sidewall disposed adjacent the cartridge body 26202 can include a recess sized and configured to receive the detent 26280 in a locking configuration. For example, channel 20852 (FIG. 99) includes distal recess 20853. The recess is configured to retain the detent 26280, and thus the staple cartridge 26200, against the channel until the detent 26280 is moved to the unlocked configuration. In other examples, the outward biasing of the detent 26280 against the channel sidewall is configured to frictionally engage the channel without placing the detent 26280 within the recess. Opposing detents 26280 on either side of staple cartridge 26000 are configured to frictionally engage the channel to retain staple cartridge 26000 within the channel.

A detent 26280 is housed within the distal-most staple cavity 26210 within the outer row 26212c. A through hole 26205 is defined within the outer wall 26203 of the cartridge body 26202 within the distal staple cavity 26210 within the outer row 26212c. The detent 26280 is aligned with the through hole 26205 and protrudes from the cartridge body 26202 at the through hole 26205 when the detent 26280 is in the locked configuration (FIGS. 54-57). Bar 26282 extends from detent 26280 and is operably engaged with driver 26220 within distal-most staple cavity 26210.

When the distal-most driver 26220 is in the unfired position (FIGS. 54-57), the distal-most driver 26200 can bias the detent 26280 to the locked position. 58 and 59, upon completion of the firing stroke, as the distal-most driver 26200 is lifted through the staple cavity toward the tissue support deck 26204 by the sled, the distal-most driver 26220 It can move away from 26280 and engage bar 26282. As the distal-most driver 26220 moves along the bar 26282, the driver 26220 is configured to force the bar laterally outward, which causes the detent 26280 to move into and/or out of the through hole 26205. through and pivot inwardly out of engagement with the channel. In such an example, upon completion of the firing stroke, the distal-most driver 26220 releases the snap mechanism or detent 26280.

In certain examples, multiple driver-releasable detents may be disposed along the length of cartridge body 26202. In certain examples, longitudinally staggered and/or longitudinally symmetrical detents may be disposed along both sides of the cartridge body 26202. In addition to driver releasable detents 26280, the threads may be configured to release snap-fit or detent mechanisms in certain aspects of the present disclosure. Further, in certain examples, the driver(s) may be configured to snap or break the detent 26280 and/or its bar 26282 during the firing stroke to release the attachment mechanism.

In various cases, the staple cartridge assemblies herein may include a driver retention mechanism configured to prevent release of the driver from the cartridge body. For example, certain staple cartridges include a metal pan that is heat staked or thermoformed to the cartridge body after the driver is installed within the fastener cavity. The metal pan(s) can wrap around the underside of the cartridge body and hold the driver therein. In certain examples, the driver may be retained without a separate metal pan to create additional space within the small form factor of the cartridge assembly. For example, a heat swage between the cartridge body and the driver can retain the driver, as described further herein. Additionally or alternatively, the cartridge body may be overmolded with a metal pan. For example, the driver retention mechanism may include a thermoformed interference feature between the driver and the cartridge body, and/or an insert molded component within the cartridge body.

A staple cartridge 26300 is shown in FIGS. 60 and 61. Staple cartridge 26300 is similar to staple cartridge 20100 (FIG. 24) in many aspects. For example, staple cartridge 26300 includes a cartridge body 26302 that includes a tissue support deck 26304 with staple cavities defined therein, the staple cavities being arranged in three longitudinal rows 26312a, 26312b, 26312c on each side of cartridge body 26302. Placed. The staples in staple cartridge 26300 are supported by driver 26320 (FIG. 61), which is similar in many aspects to triple driver 20120 (FIG. 26). For example, driver 26320 includes three parallel staple support cradles configured to support staples such that driver 26320 is configured to fire staples from inner row 26312a, middle row 26312b, and outer row 26312c. including.

Cartridge body 26302 includes a row of depressions 26330 or dimples along a lower portion of cartridge body 26302. The row of indentations 26330 can be arranged to engage and retain driver 26320 when driver 26320 is in an unfired position. In FIG. 60, each indentation 26330 is configured to engage a driver 26320. For example, each driver 26320 may be held in place by a recess 26330 adjacent the outer surface of an adjacent staple post. Recesses 26330 within cartridge body 26302 can prevent drivers 26320 from falling out of cartridge body 26302 when drivers 26320 are in their unfired and lowest positions.

A recess 26330 in the cartridge body 26302 is configured to engage a recess 26321 in the outer surface of the driver 26320. Recess 26321 can include an upper lip or border that prevents vertical displacement of driver 26320 relative to cartridge body 26302. In various cases, the indentations 26330 and corresponding recesses 26320 may be thermoformed, melted, or otherwise coupled with a heat staking process. Heat staking is further described herein.

Because the driver 26320 is a triple driver, a heat swage connection between the outer wall of the driver 26320 and the cartridge body 26302 can hold the entire driver 26320, including the middle strut and the inner strut, in place within the cartridge body 26302. . The interference connection between the recesses 26330 and the recesses 26321 may be overcome by the sled during the firing stroke to sequentially release and lift the driver 26320 as the sled moves along the row of recesses 26330. In certain cases, a series of thermal swages along the inner surface within the cartridge body 26302 can engage each driver 26320 during the firing motion. In such an example, driver 26320 may capture multiple vertical clasps or dimples during the firing motion.

In certain examples, the driver and cartridge body can include an interference feature molded into the driver and/or cartridge body. Referring to FIG. 62, staple cartridge 26400 is similar in many aspects to staple cartridge 20100 (FIG. 24). For example, the staple cartridge 26400 includes a cartridge body 26402 that includes a tissue support deck 26404 with staple cavities 26410 defined therein, the staple cavities 26410 being arranged in three longitudinal rows on each side of the cartridge body 26402. . The staples in staple cartridge 26400 are supported by driver 26420 (FIG. 62), which is similar in many aspects to triple driver 20120 (FIG. 26), except that driver 26420 is a double driver. The retention mechanism described herein with respect to driver 26420 may be incorporated into a single driver and/or triple driver in other instances.

The driver 26420 includes an integrally formed wedge 26421 that is narrower along the upper edge 26423 of the wedge 26421 and thicker along the lower edge 26425 of the wedge 26421. Wedge 26421 is disposed on the sidewall of the staple post and is configured to abut the sidewall of staple cavity 26410. For example, staple cavity 26410 includes a vertical groove 26405 that is aligned with wedge 26421. Wedge 26421 is configured to move along vertical groove 26405 as driver 26420 is lifted upwardly by the sled during a firing stroke. To accommodate the wedge 26421, the cartridge wall is configured to flex outwardly when the driver 26420 is inserted into the cartridge body 26402. In use, the firing force by the sled is sufficient to overcome the interference fit and lift the driver 26420. Stated another way, in the illustrated embodiment, wedge 26421 is configured to travel through vertical groove 26405, however, the depth of groove 26405 is sufficient to allow wedge 26421 to pass freely and clearly. isn't it. The narrow upper edge 26423 can fit into the groove without interference, however, between the narrow upper edge 26423 and the thicker lower edge 26425, the wedge 26421 can fit into the groove without interference , there is a possibility of interference with the cartridge body 26402. The interference connection between the wedge 26421 and the vertical groove 26405 is configured to hold the driver 26420 in place within the staple cavity 26410 during firing motion and resist downward movement, such that the wedge 26421 is in the row of recesses 26330. Interference can be overcome by the thread during the firing stroke to sequentially release and lift the driver 26420 as it traverses the cartridge body 26402. Cartridge body 26402 can continue to flex as its driver 26420 and wedge 26421 move through cavity 26410.

Referring now to FIG. 63, staple cartridge 26500 is shown. Staple cartridge 26500 includes a cartridge body 26502 that includes staple cavities defined therein, the staple cavities being arranged in three longitudinal rows on each side of cartridge body 26502. Staples 26580 within staple cartridge 26500 are supported by driver 26520, which is similar in many aspects to triple driver 20120 (FIG. 26). Staple cartridge 26500 is similar in many aspects to staple cartridge 20100 (FIG. 24); however, staple cartridge 26500 also includes a metal frame 26503 insert-molded within cartridge body 26502. Insert molded metal frame 26503 is a two-piece assembly that includes a first pan 26503a and a second pan 26503b that extend along the sides of cartridge body 26502. The pans 26503a, 26503b can be insert molded with the cartridge body 26502 and snap onto the cartridge body 26502 by a friction fit between the boss 26505 along the length of the cartridge body 26502 and the opening 26507 in the pan 26503a, 26503b. The bosses 26505 can be fitted and/or heat staked to the cartridge body 26502 by deforming the bosses 26505 along the length of the cartridge body 26502 within the openings 26507 of the pans 26503a, 26503b.

In one aspect, a flat, unbent pan can be insert molded with the cartridge body 26502 (e.g., the pans 26503a, 26503b can initially define a linear profile instead of an L-shaped profile). ). Cartridge body 26502 can be formed, for example, from a metal sheet overmolded along its lateral sides. The exposed length of the overmolded metal sheet is then bent around a portion of the underside of the cartridge body 26502 to at least partially overlap some of the staple cavities and drive the driver 26520 into the cartridge body 26502. It can be held from its underside. In certain cases, the driver may be a triple driver spanning an outer staple cavity, an intermediate staple cavity, and an inner staple cavity. The bent portion of the metal sheet can overlap or substantially overlap the lower portion of the outer staple cavity to maintain the driver within the cartridge body.

Alternatively, L-shaped pans such as pans 26503a, 26503b can be used to retain the driver within cartridge body 26502 from the underside of cartridge body 26502 without insert molding pans 26503a, 26503b into cartridge body 26502. It can be snapped onto the lateral sides of the cartridge body.

In one aspect, the pans 26503a, 26503b can be insert-molded with the cartridge body 26502 and include an exposed bendable metal flange or It can include an arm. For example, referring now to FIGS. 64 and 65, a portion of a metal frame or pan 26603 for a cartridge body, such as cartridge body 26502 (FIG. 63) or cartridge body 20102 (FIG. 24), is shown. Pan 26603 can be insert molded with the cartridge body. For example, pan 26603 includes a frame portion 26605 upon which the cartridge body is molded. Pan 26603 also includes arms 26609. Arm 26609 is deformed from the initial configuration (FIG. 64) to the flexed arm 26609' configuration (FIG. 65) with a deforming force in direction F (FIG. 65) to wrap arm 26609 around the lower portion of the staple cavity and drive the driver. can be held within it.

In various aspects of the present disclosure, various techniques for forming a piece of metal over the outer staple cavity to retain the driver therein may be applied to the inner staple cavity in certain cases. For example, in various aspects of the present disclosure, the staple cartridge may include a support brace, such as support brace 650 fitted within staple cartridge 640 (see FIGS. 19 and 20). As further described herein, staple cartridge 640 and support brace 650 may be assembled together prior to installing staple cartridge 640 within channel 630. In certain examples, such support braces 650 or other insert-molded longitudinal frame members within the cartridge body can include metal sheets, pans, or arms that are positioned within the inner row staple cavities. can be bent around the underside of the cartridge body to hold the driver in place.

As described herein, the driver retention and/or interlock mechanism with the cartridge body may be heat swaged to retain the driver within the cartridge body. In at least one aspect of the present disclosure, each driver can include a thermal staking mechanism corresponding to the cartridge body. It may be important to ensure that the depth of the heat swage is sufficient to prevent the drivers from disengaging, but does not cause interference with drivers in their unfired or down positions. . Thermal staking and track forming techniques can be controlled to ensure sufficient engagement.

Referring now to FIG. 67, a portion of a staple cartridge 26700 is shown including a cartridge body 26702 having a driver 26720 therein. Staple cartridge 26700 is similar to staple cartridge 20100 (FIG. 24) in many aspects, but additionally includes a longitudinal support frame 26703 and a heat swage retention mechanism 26705 between cartridge body 26702 and longitudinal support frame 26703. include. In various cases, heat staking can be performed on a solid sheet of metal to secure the cartridge body 26702 to the longitudinal support frame 26703. Driver 26720 can then be installed within the staple cavity. For example, driver 26720 and staples may be installed within staple cavity 26710. After the driver 26720 is installed, the longitudinal support frame 26703 can be bent over the underside of the cartridge body 26702 to retain the driver 26720 therein. For example, a portion 26709 of the longitudinal support frame 26703 can cover an opening in the underside of the staple cartridge body 26702 associated with the driver 26720 and the outer staple post on the outer staple cavity 26710.

Insert supports can be utilized in certain heat staking operations that can reduce the amount of pressure and improve consistency. For example, a removable insert support or backer can be placed behind each heat stake. Furthermore, the insert support can force the driver into an upper position during staking to protect the driver from deformation or other effects of the heat staking operation.

Referring to FIG. 67, a heat staking operation for staple cartridge 26800 is shown, with cartridge body 26802 secured to longitudinal support frame 26803 by heat swage 26805. Staple cartridge 26800 is similar in many aspects to staple cartridge 20100 (FIG. 24), but also includes a longitudinal support frame 26803 and a heat stake 26805. Longitudinal support frame 26803 includes an upright seat 26808 and orthogonal flanges 26809 extending therefrom to form an L-shaped profile. Upright sheet 26808 includes an opening 26807 therethrough that is aligned with heat swage 26805. Orthogonal flange 26809 also includes an opening 26806 therethrough, which is configured to receive finger 26892 of insert support 26890 therein.

During a heat staking operation, L-shaped support frame 26803 is positioned along the length of cartridge body 26802 and insert support 26890 is inserted into staple cavity 26810 with fingers 26892 passing through openings 26806 in orthogonal flange 26809. It is arranged to extend relative to the support frame 26803 and the cartridge body 26802. Fingers 26892 are configured to push driver 26820 upwardly toward tissue support deck 26804 of cartridge body 26802. After the heat swage 26805 is formed between the cartridge body 26802 and the L-shaped support frame 26803, the insert support 26890 can be removed from the staple cartridge 26800 and the driver 26820 moves downwardly into the staple cavity 26810. allows them to take their unfired positions. The orthogonal flange 26809 is configured to cover a portion of the lower surface of the cartridge body 26802 and overlap a plurality of staple posts (e.g., an outer post and a middle post) and/or a bridge between two adjacent staple posts to provide staple support. A driver 26820 spanning multiple rows of cavities 26810 may be retained within the cartridge body 26802.

As further described herein, certain end effector components may be constructed using 3D printing techniques to improve component capabilities. In certain examples, 3D printing can enable printed components to exhibit metamaterial properties, for example. Metamaterials are synthetic composite materials whose structures exhibit properties not normally found in natural materials. 3D printing is one technique used to create metamaterials by forming components with two or more materials and/or structures within them. In other examples, insert molding and overmolding can produce composite components that can have metamaterial properties in certain cases.

Composite end effector components may exhibit greater structural strength and stiffness, while allowing precision in the formation of small detailed features, and in certain cases may provide improved frictional properties. For example, a metal-plastic composite cartridge body can exhibit certain metamaterial properties in that it can be stronger and more rigid than, for example, a similar injection-molded, all-plastic, or composite cartridge body. On the other hand, it still allows precision with respect to small detailed features. In certain cases, the metal-plastic composite cartridge body can exhibit improved frictional properties for a driver movably disposed within each staple cavity. Certain composite metal-plastic components can be formed by insert molding or overmolding. In other examples, 3D printing can enable the creation of complex shapes and/or material combinations that would otherwise be too expensive and time-consuming to manufacture with traditional molding techniques. or, in certain instances, may even be impossible to manufacture without 3D printing technology.

Referring to FIG. 69, for example, a composite metal-plastic cartridge body 30002 is shown. Composite metal-plastic cartridge body 30002 can provide metamaterial properties in certain cases. Additionally or alternatively, composite metal-plastic bodies can allow for improved integration of electronic components such as electronic sensors and flexible circuits.

In one aspect, the cartridge body 30002 is formed from a stamped metal frame 30001 or two or more pans stamped and otherwise formed into the skeletal shape of the cartridge body 30002. A plastic material 30003 is then molded onto the metal frame 30001. In such a case, the metal frame 30001 can be insert molded into the plastic material 30003. The metal-plastic composite cartridge body 30002 can exhibit increased strength and folding stiffness compared to an all-plastic cartridge body, ie, an injection molded cartridge body without an internal metal frame. A plastic material 30003 on a metal or composite frame can provide a structurally functional frame with a complex driver guide mechanism molded within the plastic material 30003.

The metal frame 30001 can include a thin metal framework, and a plastic material can be injection molded with the structural members in certain examples. In one aspect, the metal frame is an integral one or two metal frame that can save space within the cartridge body and/or increase tissue clearance, as further described herein. The above bread can be composed. Additionally, metal may be utilized for some components related to lockout, cartridge identification, and reset. Metals are less prone to breakage or cracking in certain cases, can withstand large forces, and can prevent lockout components and/or mechanical keys (e.g., extension tabs or posts) from mismatching channels and/or posts in staple cartridges. or may be useful to prevent insertion into a device. Certain metal components may be resilient during firing stroke reset, i.e., when retracting the sled during manufacturing to test the cartridge and ensure all components are in place. Additionally, the composite metal-plastic cartridge body can facilitate smart cartridge technology, integrated wiring, and/or flexible circuitry.

In certain examples, the metal frame 30001 can have flanges that interconnect or span multiple walls and/or columns within the cartridge body. For example, certain walls within the cartridge body can be thinner than others, and flanges connect the thinner wall to the thicker wall to better handle torque loads rather than twisting the support. Can be dispersed. In certain examples, a main upright support wall within the cartridge body may be connected to an adjacent thicker support wall by a metal frame. For example, a thinner inner cartridge wall can be coupled to a thicker outer cartridge wall to improve force distribution during clamping and/or firing.

In other examples, composite plastic-metal cartridge bodies can be 3D printed. The orientation of the 3D construct forming the composite plastic-metal cartridge body can be optimized to ensure smooth driver movement during the firing stroke. For example, referring again to FIG. 69, cartridge body 30002 includes staple cavities 30010 arranged in a plurality of longitudinal rows 30012. A staple cavity 30010 is defined within the cartridge body 30002 through the tissue support deck 30004. A driver, such as driver 20120 (FIG. 26), described further herein, can support staples within cartridge body 30002.

The composite plastic-metal cartridge body 30002 can be printed in layers along the longitudinal axis A of the cartridge body 30002. Stated another way, the orientation of the 3D construct can be orthogonal to the longitudinal axis A and/or orthogonal to the tissue support deck 30004. When the directional 3D printing of the cartridge body 30002 is perpendicular to the longitudinal axis A (eg, proximal to distal), the build layer may be aligned with the direction of movement of the driver during the firing stroke. Referring again to FIG. 69, each staple cavity 30010 extends along an axis D that is perpendicular to the longitudinal axis A. As the sled moves through the cartridge body 30002 along the longitudinal axis A, each driver is lifted upwardly toward the tissue support deck 30004 along its respective D axis. The building direction is parallel to the D-axis of the staple cavity, along which the driver moves during the firing stroke. Aligning the 3D build layer with the direction of motion of the driver can, in some cases, prevent the driver from binding and hanging up as it is lifted by the sled during the firing stroke.

The 3D construction for the composite plastic-metal cartridge body is in some cases proximal to distal. In other examples, the 3D construct can be distal to proximal, for example. Support structure for certain 3D constructs may be minimized in certain instances when building a narrower body portion over a wider distal nose of the cartridge body.

In various cases, 3D printed composite cartridge bodies have been fabricated with different fill rates and/or to obtain metamaterial properties associated with improving cartridge body strength while minimizing frictional forces during the firing stroke. or can include different materials. Further, the support walls of such cartridge bodies may define open spaces, voids, and/or cells therebetween. In various cases, spaces between support walls (eg, thin walls between staple cavities, etc.) may be configured to allow for improved bending resistance during clamp loading. For example, the spaces between the support walls of the cartridge body can include 3D printed internal fillets, chamfers, and/or struts that are configured to improve the open cell strength of the support walls.

Certain cartridge bodies described herein have a smaller cross-sectional profile, less material, and/or A thinner support wall may be included, which takes up area in the compact form factor of the cartridge body. High loads on the cartridge body during the firing stroke can exert deforming forces on the cartridge body, which can result in deformation of the cartridge body or a portion thereof. For example, thin walls separating staple cavities may have a tendency to flex or buckle in certain cases, which can cause the driver and staples supported thereon to move out of alignment with molded pockets within the anvil. Can be oriented to come off. In any case, connecting the lateral sides of the cartridge body with bridges can strengthen the cartridge body, and even when subjected to high loads, the staples in the staple cavity and those in the anvil can be It can help maintain alignment between associated molded pockets.

71 and 72, portions of surgical end effector 30140 are shown. Surgical end effector 30140 is similar to surgical end effector 20240 (FIG. 29) in many aspects. For example, end effector 30140 includes a staple cartridge 30100 that is similar in many aspects to staple cartridge 20100 (FIG. 24), including a cartridge body 30102 and a drive screw 261 (see FIGS. 4 and 5) in many aspects, such as A rotary drive screw 30142 (FIG. 72), which is similar to rotary drive screw 20242 (FIG. 29), includes three rows of staple cavities on each side. Staple cartridge 30100 is installed within channel 30150. A firing member 30144 having an upright cutting edge 30146 moves along the rotary drive screw 30142 through the staple cartridge 30100 during a firing stroke to advance the sled and lift the driver and staples on the sled into the anvil. The molded pocket is configured to be in molded contact with the molded pocket.

The cartridge body 30102 is similar in many aspects to, for example, the cartridge body 20102 (FIG. 24), however, the cartridge body 30102 includes a bridge 30106 extending between two lateral sides 30102a, 30102b of the cartridge body 30102. further including. The bridge 30106 covers a longitudinal knife receiving slot 30108 defined within the cartridge body 30102, along which a portion of the firing member 30144 moves during the firing stroke. The bridge 30106 forms a continuous tissue support deck 30104 between the two lateral sides 30102a, 30102b of the cartridge body 30102. In various cases, the bridge 30106 can improve the strength of the cartridge body 30102, e.g., to maintain staple alignment with molded pockets on the anvil, especially when firing under high loads. can be helpful. In such instances, the bridge 30106 can alleviate lateral staple misalignment resulting from, for example, high clamp loads.

The bridge 30106 is a weakened portion and is configured to be cut or traversed by the upright cutting edge 30146 of the firing member 30144 during the firing stroke. In various cases, the shape of bridge 30106 is configured to reduce the risk of tearing. For example, the shape can allow for a predictable shape and orientation of bridge 30106 fracture. If the cartridge body 30102 is 3D printed, for example, the cartridge body 30102 may include different materials, different fill rates, and/or different fill rates along the bridge 30106 or portions of the bridge 30106 compared to adjacent portions of the cartridge body 30102. A filling feature may be included that further facilitates removal of the bridge 30106 during the firing stroke without damaging the firing member 30144 and/or fracturing the cartridge body 30102 from firing loads. can.

In certain cases, as further described herein, the staple cartridge 30100 may include a single-use knife that can cut off the bridge 30106 during the firing stroke, for example. If a single-use knife is utilized, there is no risk that the knife will dull due to subsequent firing strokes when cutting the weak portion of the bridge 30106. Bridge 30106 can include, for example, a plastic molded and/or 3D printed component that can be easily cut by upright cutting edge 30146 without significant resistance. In other examples, a reusable knife can be used to cut the bridge 30106.

In certain cases, the bridge 30106 can include a row of perforations and/or break lines/tear lines along which the bridge 30106 is configured to separate from the cartridge body 30202. Referring to FIG. 73, for example, a tamper-evident lid 30200 includes a frangible portion 30206 having a break tab 30202 and defined by a break line 30204 between the frangible portion and the remainder of the lid 30200. The frangible portion 30206 can be removed or separated from the tamper evident lid 30200 along the break line 30204. Similarly, the bridge 30106 can be removed from the cartridge body 30102 along a break line that facilitates separation of the bridge 30106 from the cartridge body 30102. In certain cases, the bridge 30106 may be interrupted by a pocket along the sidewall of the knife receiving slot 30108. The deflected and/or separated portions of the bridge 30106 may be configured to move into the pocket during the firing stroke rather than being pushed out of the cartridge body 30102 and into the tissue clamped therebetween. can.

In certain cases, as further described herein, the replaceable staple cartridge can include a single-use knife, which provides a fresh cutting edge for each firing stroke. It is possible. However, in order to cut tissue clamped between the jaws of the end effector, the knife must in various cases extend beyond the tissue support deck of the staple cartridge. Such protruding knives and cutting edges run the risk of unintended and/or inadvertent contact outside the firing stroke, which can damage tissue and/or blunt the cutting edge. obtain. For example, the cutting edge may inadvertently contact and/or cut patient and/or clinician tissue prior to the firing stroke, such as when the staple cartridge is loaded into an end effector. In other examples, upon completion of the firing stroke, the cutting edge may remain in a distally extended position, allowing the patient and/or clinical Medical tissue may be inadvertently touched and/or cut. Further unintended tissue contact scenarios are envisioned.

In various cases, the tissue cutting knife may be attached to a thread within the staple cartridge. As the sled moves through the firing stroke, the knife can also move through the cartridge body. Additionally, the sled can interact with a firing member (eg, an I-beam or an E-beam) within the end effector. For example, the sled and knife thereon may be releasably coupled to the firing member such that the sled and knife advance distally during the firing stroke. In certain instances, the sled and knife may be retracted proximally with the firing member upon completion or termination of the firing stroke. In such a case, the knife can be reset and/or returned to a proximal position within the cartridge body before the firing member allows the jaws to open. In such case, the protruding knife and its cutting edge may return to a predictable and/or at least partially shielded position at the proximal end of the cartridge body. In other cases, the thread can include multiple separable components (e.g., a two-part thread), and one part of the thread can be retracted proximally while another part of the thread can be retracted proximally. The portion remains in the distal position. In certain embodiments, the retractable portion of the sled can include a knife. In yet other examples, the non-retractable portion of the sled may include a knife, and the knife may be directed downwardly into the cartridge body as the retractable portion of the sled passes the knife. In certain instances, a portion of the thread may interact with a lockout mechanism to prevent a firing stroke when the cartridge is lost and/or spent.

In one aspect of the disclosure, the firing member can include a distally extending hook and the sled can include a proximal cavity dimensioned to receive the distally extending hook. Further, the knife may be pivotally connected to the sled and arranged to selectively engage and retain a distally extending hook within the sled. For example, a distally extending hook can be hooked around a portion of the knife. In various cases, the interconnection between the distally extending hook and the knife is configured to retain the knife in a protruding position relative to the cartridge body.

In such a case, the knife can be moved to an extended position in which the cutting edge cuts through the tissue clamped between the jaws as the firing member advances to engage the sled. Placed for resection. Prior to the firing stroke, the knife can be pivoted to a shielded position in which at least a portion of the cutting edge is shielded by the sled and/or the cartridge body. Further, upon completion of the firing stroke, the firing member can return to its proximal position within the cartridge body with the sled and return to its shielded position. In various cases, the aforementioned configuration may avoid certain inadvertent tissue contact outside of the firing stroke.

Referring now to FIGS. 74-77, a sled assembly 30320 for an end effector 30340 (FIG. 77) is shown. End effector 30340 is similar in many aspects to end effector 200 (see FIGS. 4 and 5) and is configured to cut and staple tissue of a patient. The end effector 30340 may include, for example, a cartridge jaw and an anvil jaw, and the cartridge jaw may be configured to receive a staple cartridge 30300 having a tissue support deck 30304, which in many aspects , for example, the staple cartridge 220 (see FIGS. 4 and 5). End effector 30340 also includes a rotary drive screw and firing member 30342, which are similar to firing screw 261 (see FIGS. 4 and 5) and firing member 270 (see FIGS. 4 and 5), respectively. The cartridge jaws are configured to receive a staple cartridge 30300 containing staples that may be ejected when the firing member 30342 is advanced within the staple cartridge 30300. For example, firing member 30342 is driven through end effector 30340 as the firing screw rotates during a firing stroke to advance sled assembly 30320.

Firing member 30342 includes a body portion 30343, an upper cam member 30344 extending laterally from opposite sides of body portion 30343, and a lower cam member 30345 extending laterally from opposite sides of body portion 30343. Upper cam member 30344 is configured to cam engage the upper jaw or anvil of end effector 30340 during the firing stroke, and lower cam member 30345 is configured to cam engage the lower jaw or anvil of end effector 30340 during the firing stroke. The channel is configured for camming engagement with the channel.

In addition to the above, a longitudinal opening extends through the body portion 30343. The longitudinal opening is configured to receive the rotational drive screw described above. Body portion 30343 further includes a cutout region 30349 configured to receive a firing drive nut 30350. Firing drive nut 30350 is configured to threadably engage the rotary drive screw to convert rotational movement of the rotary drive screw into translation of firing member 30342. Firing drive nut 30350 also includes laterally extending members 30351 extending from opposite sides of firing drive nut 30350. Laterally extending member 30351 is aligned with lower cam member 30345. Thus, cam members 30345, 30351 cooperate to cam the lower jaw of end effector 30340 during the firing stroke.

The body portion 30343 of the firing member 30342 also includes a distal nose portion 30346 that extends distally and forms a distal thread abutment surface 30352. A distal extension 30347 extends substantially distally from the distal sled abutment surface 30352 and is configured to selectively interlock with the sled assembly 30320. More specifically, distal extension 30347 includes a transverse portion or fastener 30348 that extends transversely in the distal direction. Distal extension 30347 and fastener 30347 form a hook shape that selectively engages a portion of sled assembly 30320, as further described herein.

Sled assembly 30320 includes a sled body 30321 and a knife 30338 having a rail 30322 positioned to engage a driver, such as, for example, driver 20120 (FIG. 26). The rail 30322 is configured to lift the driver toward the tissue support deck 30304 of the staple cartridge 30300. The central portion 30333 of the sled body 30321 moves along a central longitudinal path within the staple cartridge 30300 during the firing stroke. In various embodiments, the central portion 30333 includes an upright hub 30334 having a sidewall 30335 that is sized and configured to move along a longitudinal slot within the staple cartridge 30300. The central portion 30333 also includes an arcuate lower profile 30334 sized and positioned to accommodate the rotational drive screw without interference.

Upright hub 30334 includes a recess or space 30328 between sidewalls 30335 and a shaft or pin 30336 extending between sidewalls 30335. A stop 30337 also extends between the sidewalls 30334 and is further described herein. Knife 30338 of sled assembly 30320 is pivotally mounted to pin 30336 at hub 30339. In various aspects, hub 30339 can define a hub diameter that allows rotation of knife 30338 about pin 30336. Additionally, knife 30338 includes a mounting slot 30329 having a width less than the hub diameter and through which pin 30336 passes to secure hub 30339 to pin 30336. In various cases, knife 30338 can be snapped or press-fit onto pin 30336, for example. Referring to the exploded view of sled assembly 30320 in FIG. 75, knife 30338 can be moved along assembly axis A to rotatably attach knife 30338 to sled body 30321.

In various cases, the knife 30338 can pivot relative to the sled body 30321 into a downward or recessed position. For example, the knife 30338 and its cutting edge can, for example, point generally downward and/or be shielded by the sidewall 30335 when the knife 30338 is in the recessed position. In certain examples, the biasing element is configured to bias the knife 30338 toward the recessed position.

Referring now primarily to FIG. 77, during a firing stroke, firing member 30340 is advanced distally into staple cartridge 30300 as it inserts distal extension 30347 and fastener 30348 into sidewall 30335 of upright hub 30334. into the space 30328 between. Once inserted into the space 30348, the fastener 30348 can be hooked around the end 30328 of the knife 30338. The end 30328 of the knife 30338 defines a flat abutment surface 30327 and the bulbous end 30327 extends with the catch 30348 to securely hold the fastener 30348 against the flat abutment surface 30327. In such a case, the catch 30348 is retained within the space 30328 at a location distal to the end 30328 of the knife 30338. Additionally, the knife 30338 is rotated to an extended position in which the cutting edge projects out of the cartridge body 30302 and into the tissue gap defined between the tissue support surface 30304 and the anvil. In various cases, the distal extension 30347 and/or the end 30328 flex under a predetermined load during the distal firing motion to resiliently push the distal extension 30347 into the space 30328 of the sled assembly 30320. configured to connect.

Firing member 30340 can then advance sled assembly 30320 distally. As the sled assembly 30320 moves distally, the knife 30338 is pushed in a clockwise direction from the orientation shown in FIG. 77. Resistance to firing motion (eg, tissue) can be configured to rotate knife 30338 in a clockwise direction. The knife 30338 can be rotated in a clockwise direction from the orientation of FIG. 77 into abutting engagement with a stop 30337 configured to prevent further clockwise rotation of the knife 30038. In such cases, the knife 30338 is maintained in an upright or extended position relative to the tissue support deck 30304 during the distal movement of the firing stroke. For example, the abutment surface 30327 can be flush or substantially flush with the inner surface of the fastener 30348.

Proximal retraction movement of the firing member 30320 is shown in FIG. 77, with the firing member 30320 being withdrawn in the proximal direction P. Retraction of firing member 30320 in proximal direction B is configured to pull distal extension 30347 and fastener 30348 proximally, thereby applying a force proximally to end 30328 as well. Ru.

This force on end portion 30328 is then configured to rotate knife 30338 in a counterclockwise direction while retracting sled assembly 30320 with firing member 30320. In various cases, slight clockwise rotation of the knife 30338 is configured to, for example, pivot the cutting edge of the knife 30338 downward into an orientation that is less likely to contact and/or cut tissue. ing.

In various cases, the interconnection between the firing member 30340 and the sled assembly 30320 may cause the sled to open before the jaws are released from engagement by the cam members 30344, 30345, 30351 of the firing member 30340 and are allowed to open. Assembly 30320 and its knife 30338 are configured to ensure that they are reset to a proximal position within staple cartridge 30300. As firing member 30340 is further retracted and withdrawn from staple cartridge 30300, distal extension 30347, catch 30348, and/or end 30328 release distal extension 30347 from sled body 30321 and release knife 30338. It may be configured to deflect further counterclockwise from the orientation of FIG. 77 to the occluded orientation.

In certain aspects of the present disclosure, threads may be stamped from metal sheets. In some cases, the thread may be a two-part thread formed from two die cut sheets. The stamped thread can have a substantially W-shaped profile in certain examples. The knife can, for example, be integrated into one of the punched sheets. In certain examples, a two-part sled can include a first punched component that is retractable with the firing member and a second punched component that is not retractable with the firing member. In the proximal unfired position, the second punching component is configured to interact with and overcome lost and spent cartridge lockouts. In a distal firing position where the second punching component is not retracted by the firing member, the lost and spent cartridge lockout is configured to engage the firing member and prevent the firing stroke.

The two-part thread and lockout configuration can prevent the firing stroke when a staple cartridge is missing from the end effector and/or when a used or empty staple cartridge is installed within the end effector. . Additionally, a sled formed from two stamped metal sheets may provide a lower cost sled and, in certain cases, an integrated knife and cutting edge, a coupling mechanism for the firing member, and It has a lockout engagement mechanism. Such stamped metal threads can prevent bending or expansion of the thread rail under high staple forming loads, and can prevent thread breakage or cracking in certain cases. Additionally, the stamped metal threads can define thin rails that allow for more plastic (or other material(s)) within the cartridge body, which increases the strength of the support wall between the staple cavities. The strength of the cartridge body containing the material can be improved. In certain instances, the thin profile of the stamped metal threads can allow the drivers to be placed closer together, which in certain cases can better accommodate rotational drive screws. .

Referring now to FIGS. 74-89, a sled assembly 30420 for an end effector 30440 (see FIG. 82) is shown. End effector 30440 is similar in many aspects to end effector 200 (see FIGS. 4 and 5) and is configured to cut and staple tissue of a patient. The end effector 30440 includes, for example, a cartridge jaw 30450 and an anvil jaw 30454, where the cartridge jaw 30450 is configured to receive a staple cartridge 30400 having a cartridge body 30402 and a tissue support deck 30404, which in many aspects , for example, the staple cartridge 220 (see FIGS. 4 and 5). The end effector 30440 also includes a firing drive system 30339 that includes a rotary drive screw 30442 and a firing member 30441, which respectively fire screw 261 (see FIGS. 4 and 5) and firing member 270 (see FIGS. 4 and 5). It is similar to Cartridge jaw 30450 defines a channel with opposing sidewalls 30452 configured to receive staple cartridge 30400 containing staples that may be ejected as firing member 30441 advances through staple cartridge 30400. For example, firing member 30341 is driven through end effector 30340 to advance sled assembly 30420 as rotary drive screw 30442 rotates during a firing stroke.

Referring primarily to FIG. 81, firing member 30441 includes a body portion 30443, an upper cam member 30444 extending laterally from opposite sides of body portion 30443, and a lower cam member 30445 extending laterally from opposite sides of body portion 30443. including. Upper cam member 30444 is configured to cam and engage anvil jaw 30454 of end effector 30400 during a firing stroke, and lower cam member 30445 cams to engage cartridge jaw 30450 of end effector 30440 during a firing stroke. configured to engage with each other.

In addition to the above, a longitudinal opening extends through the body portion 30343. The longitudinal opening is configured to receive the rotational drive screw 30442 described above. In certain examples, the rotary drive screw 30442 can be threadably coupled to the body portion 30343, and in other examples, to a firing drive nut housed therein, as further described herein. They can be coupled together in a screwable manner.

Referring primarily to FIGS. 78-81, sled assembly 30420 includes two separate threads: a proximal thread 30422 and a distal thread 30424. Each thread 30422, 30424 is a separate individual stamped component. For example, each thread 30422, 30424 can be formed from a separate stamping. Threads 30422, 30424 are formed from stamped sheets of material, such as metal sheets. In at least one embodiment, the threads 30422, 30424 are formed from sheet steel, although other materials are also contemplated. Proximal thread 30422 and distal thread 30422 cooperate to engage driver 30416 contained within cartridge body 30402. Driver 30416 may be a triple driver in various cases, and may be similar in many aspects to driver 20120 (FIG. 26), for example.

Proximal thread 30422 and distal thread 30424 can be connected with a push connection. Stated another way, the threads 30422, 30424 may remain connected while the proximal thread 30422 applies a pushing force to the distal thread 30424. Without a pushing force, the sleds 30422, 30424 are separable components and can optionally be selectively moved and repositioned.

Each sled 30422, 30424 includes a pair of stamped wedges that form a rail. Proximal sled 30422 includes an outer rail 30423 for sled assembly 30420 and distal sled 30424 includes an inner rail 30425 for sled assembly 30420. Outer rail 30423 and inner rail 30425 may be configured to move along each side of the staple cartridge during the firing stroke and may be aligned with the row of drivers 30416. Between the rails 30423, 30425, the proximal and distal sleds 30422, 30424 include central upright portions 30426, 30428, respectively, which receive a rotational drive screw 30442 (FIG. 81) therethrough. As such, lower arcuate contours 30426a, 30428a are defined. The central upright portions 30426, 30428 also include keys 30426b, 30428b, respectively, which are configured to align and guide the threads 30422, 30424 through the cartridge body 30402. The keys 30426b, 30428 are arcuate loops, although other geometric shapes are also envisioned. Orthogonal flanges, for example, connect central upright portions 30426, 30428 to respective rails 30423, 30425. The orthogonal flanges have the same thickness as the associated rails 30423, 30425 due to their stamping formation.

A thread assembly 30420 is shown within the staple cartridge in FIG. 88. The thickness of the metal sheet may be correlated to the thickness of the rails 30423, 30425. In such an example, the inner rails 30423 necessarily have the same thickness and the outer rails 30423 necessarily have the same thickness. In at least one aspect, the inner rail 30423 and outer rail 30423 can be stamped separately but have the same thickness. Either way, because it is formed from a thin metal sheet, the sled assembly 30420 can have a reduced thickness while still withstanding high loads without bending and/or breaking. For example, the rails 30423, 30425 may be narrower than the cartridge walls between staple cavities in adjacent longitudinal rows. By comparison, referring to the staple cartridge 30500 of FIG. 89 having the same overall width and staple line shape, the inner rail 30523 and outer rail 30525 of the thread 30530 (e.g., a molded plastic thread) within the cartridge body 30502 are similar to the rails 30423, 30425. It can be wider than In such an example, the cartridge body 30502 may have less space, and therefore less material and associated strength, to support the inner row of drivers, for example.

Proximal sled 30422 and distal sled 30424 may be aligned and assembled along assembly axis A (FIG. 79). When assembled, the central upright portions 30426, 30428 may be longitudinally staggered and the proximal portion of the inner rail 30425 may rest on the orthogonal flange of the proximal sled 30422 (see FIG. 80). Additionally, the orthogonal flanges of both threads 30422, 30424 are configured to slide or otherwise move along a lower support surface, such as the inner surface of cartridge jaw 30450 (see FIG. 82).

Still referring to FIGS. 78-81, the proximal sled 30422 also includes an integral knife 30430 having a distally facing cutting edge 30432. Knife 30430 may be cut into the sheet of material, for example, when proximal thread 30422 is punched out. Proximal sled 30422 also includes a proximal tail or extension 30434 that fires firing member 30441 (Fig. 81) when staple cartridge 30400 and its drive assembly 30420 are installed within cartridge jaw 30450 (Fig. 82). ). Proximal extension 30434 is T-shaped and includes a lateral bias configured to facilitate coupling with T-shaped recess 30448 (FIG. 81) in firing member 30441. For example, referring to FIG. 87, proximal extension 30434 can initially reside within a notch within cartridge body 30402, which holds proximal thread 30422 in place relative to cartridge body 30402. be able to. Next, as the firing member 30442 moves distally, the proximal extension 30434 flexes into the T-shaped recess 30448 and locks the proximal sled 30422 to the firing member 30442. Alternative complementary profiles are also envisioned for coupling proximal extension 30434 and firing member 30441.

In various cases, when the staple cartridge 30400 is installed within the cartridge jaw 30450, the firing member 30441 may be aligned with the drive assembly 30420 such that the firing member 30441 initially moves during the firing stroke, as shown in FIG. Moving the distance distally may be configured to move into driving engagement with drive assembly 30420. Referring to FIG. 87, for example, as firing member 30441 begins to move proximally, deflection of proximal extension 30434 into recess 30448 is enabled.

The proximal extension 30434 can be biased into retaining engagement with a recess 30448 in the body 30443 of the firing member 30441 such that the firing member 30441 is ultimately withdrawn proximally from the staple cartridge 30400 upon completion of the firing stroke. The firing member 30441 may remain engaged with the recess 30448 during proximal and distal displacement(s) of the firing member 30441 until it is removed or substantially withdrawn from the staple cartridge 30400. When firing member 30441 is releasably attached to proximal sled 30422, upright body portion 30443 of firing member 30441 is aligned with knife 30430. As shown in FIG. 81, body portion 30443 can support knife 30430 as knife 30430 is advanced through tissue. In various cases, the additional support from the body portion is configured to prevent deflection of the knife 30430 away from the firing path and longitudinal axis of the end effector 30440.

Distal sled 30424 is pushed distally by proximal sled 30422 during the firing stroke. The distal sled 30424 further includes a foot 30429 (FIG. 86) extending downwardly from the rail 30245 and/or orthogonal flange. The foot 30429 can be configured to move through a slot in the cartridge jaw 30450 during a firing stroke when the firing member 30441 pushes against the proximal sled 30422, and the proximal sled moves through the slot in the cartridge jaw 30450 during the firing stroke. Push sled 30424 distally. In various cases, the foot 30429 is configured to engage a lockout within the end effector 30440 when the distal sled 30424 is placed in the proximal unfired position. The distal sled 30424 and its lockout mechanism are further described herein.

Referring primarily to FIGS. 82-84, end effector 30440 includes a lockout arm 30460 that is selectively engaged by distal sled 30424. The lockout arm 30460 is movable between a locked position (FIGS. 82-84) in which a firing stroke is prevented and an unlocked position (FIG. 85) in which a firing stroke is permitted. The lockout arm 30460 is flexibly disposed within a longitudinal recess 30453 in the channel portion of the cartridge jaw 30450 and, in certain examples, is configured to pivot about a central pivot portion 40646.

Lockout arm 30460 includes a proximal end 30466 that is biased into a lockout notch 30449 within firing member 30341. For example, a spring 30470 disposed within cartridge jaw 30450 is configured to force proximal end 30466 into lockout notch 30449 of firing member 30341 when firing member 30341 is in the proximal pre-fire stroke position. ing. When the proximal end 30466 of the lockout arm 30460 is received within the lockout notch 30449, the lockout arm 30460 is configured to resist translation of the firing member 30441, thus preventing a firing stroke.

Sled assembly 30420 is configured to traverse lockout arm 30460 by removing its proximal end 30466 from lockout notch 30449. More specifically, when the distal sled 30424 is placed in the proximal unfired position within the staple cartridge 30400, the foot 30429 of the distal sled 30424 engages the distal end 30462 of the lockout arm 30460. (See FIG. 85). A pivoting portion 30464 of lockout arm 30400 between proximal end 30466 and distal end 30462 is retained within an arcuate support 30451 within cartridge jaw 30450. Pivoting portion 30464, and thus the entire lockout arm 20468, is configured to pivot about arcuate support 30451 in certain examples.

For example, lockout arm 30460 pivots from a locked position to an unlocked position when staple cartridge 30400 is installed within end effector 30440 and distal sled 30424 is in a proximal unfired position, which indicates that it is unused or empty. Lockout arm 30460 pivots from an unlocked position to a locked position when firing member 30441 pushes proximal sled 30422 distally, which pushes distal sled 30422 distally. When the foot 30429 on the lower portion of the distal sled 30422 disengages the distal end 30462 of the lockout arm 30460, the lockout arm 30460 pivots under the biasing force of the spring 30470. When the firing member later returns to the proximal position after the firing stroke and attempts to move the lockout notch 30449 past the lockout arm 30460, the spring 30470 forces the proximal end 30466 of the lockout arm 30460 into the lockout notch 30449. to prevent the firing stroke. Foot 30429 moves along longitudinal recess 30453 within channel 30450 during the firing stroke.

As described herein, the two-part sled assembly 30420 is configured to selectively overcome the lockout arm 30460 and enable the firing stroke. Additionally, sled assembly 30420 includes an integral knife 30430, which is a single-use knife 30420 having a suitably sharp cutting edge 30432 for cutting tissue clamped by end effector 30440. Single use knife 30420 is retracted proximally with firing member 30441 upon completion of the firing stroke. Additionally, because the firing beam 30441 includes opposing cams 30445, 30446, the firing member 30441 ensures that the jaws 30450, 30542 remain closed until the knife 30420 is returned to a proximal position within the staple cartridge 30400. can do.

As described herein, certain surgical devices can include a reusable knife incorporated into the surgical device, such as, for example, a distally directed knife edge on a firing member. Once the firing stroke is complete, the reusable knife can be retracted from the staple cartridge and then refired with another staple cartridge. In such applications, surgical devices including reusable knives may be cleaned and sterilized between surgical procedures.

In other examples, single-use knives can be utilized with surgical devices. For example, a staple cartridge may include a single-use knife that is used only with that particular staple cartridge. When the staple cartridge is removed from the surgical device, the single-use knife is removed as well. Once the replacement staple cartridge is installed in the surgical device, a new single use knife is provided with the surgical device. In certain examples, the single-use knife can remain within the staple cartridge for the duration of the firing stroke and even after the firing stroke when the staple cartridge is removed from the surgical device. In certain cases, the cutting edge of the single-use knife may be at least partially obscured by the mechanism of the staple cartridge after the firing stroke and/or when the staple cartridge is removed from the surgical device. In certain cases, the knife or a portion thereof may be folded or otherwise deformed and/or pushed downwardly into the staple cartridge from a protruding orientation.

For example, a staple cartridge can include a two-part thread assembly that includes a proximal thread and a distal thread. The proximal sled can be connected to the firing member upon insertion of the two-part sled assembly into the surgical device. The distal thread can include an upright cutting edge. During the firing stroke, the firing member is configured to push the proximal sled distally, which in turn pushes the distal sled distally to ablate tissue. Once the firing stroke is complete, the proximal sled can be retracted proximally by the firing member and separated from the distal sled. When the proximal sled is proximally retracted, the central ledge of the proximal sled is configured to move over the upright cutting edge and fold the cutting edge downwardly into the cartridge body. In various cases, the proximal sled can also include a support mechanism to support the upright cutting edge during the firing stroke.

In certain examples, a two-part sled assembly can be manufactured from stamped metal sheets, which can be a low cost alternative to other manufacturing techniques. Stamped metal thread assemblies may have thinner rails, but in certain instances are stronger than plastic threads for the same size staple cartridge. Additionally, the stamped metal thread assembly can form staples with less bounce and/or, in certain cases, allows the staples to be placed closer together at the staple line. In certain instances, the knife may be configured to sink and/or deform within the cartridge body at any location along the length of the firing stroke, with only the proximal stamped thread component being connected to the firing member. You can return with Folding and/or deformation of the knife during proximal retraction of the firing member and proximal stamped thread component can ensure that the knife is not reused during subsequent surgical procedures. The proximal stamped sled component and firing member may be positioned to support the distal stamped sled component and its knife during a distal firing stroke in certain instances.

Referring now to FIGS. 90-98, a two-part sled assembly 30620 is shown. Sled assembly 30620 includes two separate threads: proximal thread 30622 and distal thread 30624. Each thread 30622, 30624 is a separate individual stamped component. For example, each thread 30622, 30624 can be formed from a separate stamping. Threads 30622, 30624 are formed from stamped sheets of material, such as metal sheets. In at least one embodiment, the threads 30622, 30624 are formed from sheet steel, although other materials are also contemplated. Proximal thread 30622 and distal thread 30622 cooperate to engage driver 30616 (FIG. 92) contained within cartridge body 30602. Driver 30616 may be a triple driver in various cases, and may be similar in many aspects to driver 20120 (FIG. 26), for example.

Proximal thread 30622 and distal thread 30624 can be connected with a push connection. Stated another way, threads 30622, 30624 may remain connected while proximal thread 30622 applies a pushing force to distal thread 30624. In the absence of a pushing force, the sleds 30622, 30624 are separable components that can be selectively moved and repositioned in certain cases.

Each sled 30622, 30624 includes a pair of stamped wedges that form a rail. Proximal sled 30622 includes an outer rail 30623 for sled assembly 30620 and distal sled 30624 includes an inner rail 30625 for sled assembly 30620. Outer rail 30623 and inner rail 30625 may be configured to move along each side of the staple cartridge during the firing stroke and may be aligned with the row of drivers 30616. Proximal sled 30622 includes a central upright portion 30626 and orthogonal flanges 30621 connecting central upright portion 30426 to each outer rail 30623. The orthogonal flange 30621 is configured to ride along the lower support surface (e.g., along the inner surface of the cartridge jaw) during the firing stroke and has the same thickness as the outer rail 30423 due to the stamping formation of the proximal thread 30622 . Central upright portion 20426 is dimensioned to fit around a portion of distal sled 20624 and defines a ledge 30627.

Distal sled 30624 includes a central upright portion 30628 and orthogonal flanges 30619 connecting central upright portion 30626 to each inner rail 30625. The orthogonal flange 30619 is configured to ride along the lower support surface (e.g., along the inner surface of the cartridge jaw) during the firing stroke and has the same thickness as the inner rail 30625 due to the stamping formation of the distal thread 30624. have Central upright portion 30628 defines a lower arcuate profile 30626a that is dimensioned to receive a rotational drive screw 30642 (FIG. 92) therethrough. Rotary drive screw 30642 is similar in many aspects to firing screw 261 (see FIGS. 4 and 5). Central upright portion 30628 further includes an extending knife 30629 having a distally facing cutting edge 30630. The central upright portion 30626 of the proximal sled 30622 fits around the central upright portion 30626 of the distal sled 30622, except for the extending knife 30629 that extends beyond the upper edge of the ledge 30627 and the central upright portion 30628. It is composed of The distal sled 30624 also includes an anti-retraction arm 30632 that can be laterally biased to engage the cartridge body 30602 to prevent proximal retraction of the distal sled 30624 after a firing stroke. can. In certain cases, anti-backup arms 30632 may be positioned on each lateral side of distal sled 30624.

Referring primarily to FIG. 92, sled assembly 30620 is a component of staple cartridge 30600, which also includes a cartridge body 30602, a driver 30616, and staples removably disposed within cartridge body 30602. In various cases, the staple cartridge 30600, including its sled assembly 30620, is releasable into a surgical device or its end effector having a cartridge jaw, an anvil jaw, and a firing member, as further described herein. can be installed. Once the stapling motion is complete, staple cartridge 30600 containing thread 30620 may be removed from the end effector. When the staple cartridge 30600 is installed within the surgical end effector, the sled assembly 30620 may be aligned with the firing member within the surgical end effector, and the distal sled 30622 may be inserted into the surgical end effector when the staple cartridge 30600 is installed within the surgical end effector. The firing member may be releasably coupled to the firing member when the firing member is opened.

Referring now to FIG. 90, firing member 30641 is shown for use with sled assembly 30620. When assembled together, firing member 30641 and sled assembly 30620 form firing assembly 30639 configured to advance along rotary drive screw 30642 during a firing stroke. Firing member 30641 includes an upright body portion 30643, an upper cam member 30644 extending laterally from opposite sides of body portion 30643, and a lower cam member 30645 extending laterally from opposite sides of body portion 30643. Upper cam member 30644 is configured to cam engage the upper jaw or anvil of the end effector during the firing stroke, and lower cam member 30645 is configured to cam engage the lower jaw or elongated channel of the end effector during the firing stroke. Configured for cam engagement. Cam members 30644, 30645 clamp the jaws of end effector 30640 and define a tissue gap during the firing stroke, as further described herein with respect to various firing members (e.g., I-beams and E-beams). It is configured as follows.

As shown in FIG. 90, when a staple cartridge 30600 including a sled assembly 30620 is installed within a surgical end effector, the sled assembly 30620 is releasably engaged with a firing member 30641. More specifically, proximal sled 30622 includes proximal fingers 30638 that extend laterally inwardly in longitudinal track 30637 along each inner edge of orthogonal portion 30621. Additionally, firing member 30641 includes a ridge 30648 disposed within a respective slot 30646 to body portion 30645. The insertion angle of staple cartridge 30600 relative to firing member 30641 causes proximal finger 30641 to be raised above ridge 30648 and positioned within slot 30646 in firing member 30641 to release proximal sled 30622 into firing member 30641 to hold. Referring primarily to FIG. 95, the engagement mechanism between proximal sled 30622 and firing member 30641 is symmetrical about longitudinal axis A through staple cartridge 30600 and is similar to firing drive screw 30641 (FIG. 92). Aligned. In other examples, the engagement mechanism may be located on only one side of the firing assembly 30639.

Once the staple cartridge 30600 is properly seated within the surgical end effector and the proximal sled 30622 is releasably retained in the firing member 30641, a firing stroke may begin. At the beginning of the firing stroke, firing member 30641 is advanced distally and firing assembly 30639 assumes the first advanced configuration of FIGS. 92-95. During this initial portion of the firing stroke, firing member 30641 moves distally relative to proximal sled 30622. For example, proximal finger 30638 moves through slot 30646 in firing member 30641 as ridge 30648 moves along track 60637. Firing member 30641 is advanced distally until ridge 30648 on firing member 30641 abuts the end of track 30637, as shown in FIG. Stated another way, the proximal sled 30622 includes a hard stop 30636 at the orthogonal portion 30621 of the distal end of the track 30637 (FIG. 95). Ridge 30648 cannot move distally beyond hard stop 30636. In short, firing member 30641 moves relative to proximal sled 30622 until ridge 30648 abuts hard stop 30636, at which point firing assembly 30639 is in the first advanced configuration.

In the first advancement configuration, firing member 30641 is positioned to push proximal sled 30622 and proximal sled 30622 is positioned to push distal sled 30624. In effect, the firing member 30341 is in forceful engagement with the sled assembly 30620 and can push the collecting sled assembly 30620 distally to fire the staple and cut tissue. In the first advancement configuration, the upright body portion 30643 of the firing member 30641 is pushed distally into abutting engagement with the knife 30629. In this configuration, firing member 30641 is configured to support knife 30629 during the firing stroke.

Once the firing stroke, or a portion thereof, is complete, the firing member 30641 can be retracted proximally. Proximal retraction of firing member 30641 is configured to unclamp the jaws in various cases, as further described herein. Proximal retraction motion is shown in Figures 96A-96D. In the first retracted configuration (FIG. 96A), firing member 30641 has been proximally retracted and moved relative to sled assembly 60620, including to proximal sled 60622. For example, firing member 30641 is allowed to move proximally relative to proximal sled 60622 until ridge 30648 abuts the proximal end of track 30637. The proximal end of track 30637 is defined by proximal finger 30638 that extends laterally inwardly into slot 30645 in firing member 30641. In the first retracted configuration, the ridge 30648 abuts the distal end of the proximal finger 30638.

From the first retracted configuration, firing member 30641 is configured to retract proximal sled 30622 with firing member 30641. Anti-retraction arm 30632 on distal sled 30624 is configured to hold distal sled 30624 in place within cartridge body 30602 as proximal sled 30622 is retracted. In the second retracted configuration (FIG. 96B), the ledge 30627 on the central upright portion 30626 of the proximal sled 30622 is pulled over the upwardly projecting knife 30629, causing the knife 30629 to deform or deform downward below the ledge 30627. Fold. The central upright portion 30628 of the distal sled 30624 supporting the knife 30629 comprises an elongated beam with at least one corner or bend that can be deflected by the ledge 30627 moving over the knife 30629. The bend portion can include hollow interior corners to facilitate bending when a downward force of the ledge 30627 is applied. The central upright portion 30628 and its knife 30629 continue to be pushed downward as the firing assembly moves from the second retracted configuration to the third retracted configuration (FIG. 96C). From the third retracted configuration to the fourth retracted configuration (FIG. 96C), firing member 30641 has distal sled 30624 folded and/or deformed by ledge 30627 during proximal retraction movement of proximal sled 30622. and continues to pull proximal sled 30622 away from its knife 30639.

Referring primarily to FIGS. 97 and 98, distal sled 30624 is retained within the distal portion of cartridge body 30602, and proximal sled 30622 and firing member 30641 are retracted proximally. In various cases, after the cams 30644, 30645 of the firing member 30641 are retracted out of engagement with the cam surfaces in the anvil and cartridge jaws, the jaws can be opened and the used/fired staple cartridge removed. 30600 can be removed from the end effector. For example, the removal angle of staple cartridge 30600 allows proximal finger 30638 to be raised over ridge 30648 to disengage proximal sled 30622 from firing member 30641. In such a case, the staple cartridge 30600, which includes the shielded bent/deformed knife 30629 within the cartridge body 30602, may be removed and replaced with a new staple cartridge.

Certain staple cartridges described herein may include a central longitudinal support frame and/or a rotational drive screw that extends along a substantial length of the staple cartridge. In various cases, the structure along the center of the staple cartridge can occupy a significant portion of the staple cartridge footprint, and in particular, can occupy a significant width, which includes the staple cavity, staple driver , and the placement of staples therein. Certain modifications to the staple line can affect hemostasis. staples, such as the number of staples in longitudinal rows and the spacing between them, the lateral spacing between longitudinal rows, and variations in the number of staples, the spacing between them, and the placement (i.e., offset) of the most proximal staples; Adjustments to the line configuration can be made on a column-by-column basis. Various staple line configurations are described herein that are configured to optimize hemostasis and balance firing forces within the small footprint of the various staple cartridge assemblies described herein. has been done.

The sled experiences significant forces during the firing stroke. For example, significant lateral loads may be applied to the sled rails as the sled engages the driver and lifts the driver and staples thereon through tissue and into contact with the anvil. To smooth the firing force during the firing stroke, the staple pattern on both sides of the cartridge may be offset longitudinally.

Referring now to FIG. 118, staple cartridge 25000 has a cartridge body 25002 and a staple cavity 25010 defined within cartridge body 25002. Staple cavity 25010 is sized and configured to retain a driver and staple therein, as further described herein. A longitudinal slot 25006 divides the cartridge body 25002 into a first side 25002a and a second side 25002b. The staple cavities 25010 are arranged in two patterns: a first pattern 25014 on the first side 25002a of the longitudinal slot 25006, and a second pattern 25016 on the second side 25002b of the longitudinal slot 25006. Ru. Each pattern 25014, 25016 includes an inner row 25012a, a middle row 25012b, and an outer row 25012c. However, first pattern 25014 is different from second pattern 25016.

More specifically, the first pattern 25014 is longitudinally offset from the second pattern 25016 by a distance or longitudinal offset O. As a result, first pattern 25014 and second pattern 25016 are not symmetrical about longitudinal axis A. The first pattern 25014 includes the most proximal staple cavities and the second pattern 25016 includes the most proximal staple cavities. The longitudinal offset O between the proximal ends of the most proximal staple cavities on opposite sides of the longitudinal axis L is the longitudinal offset O.

As further described herein, the triple driver includes three staple struts connected by a bridge. The triple driver defines a longitudinal length from a proximal end of the most proximal strut to a distal end of the distal most strut. The longitudinal length is the length along the longitudinal axis A, e.g., the proximal length of a driver configured to fire staples from the first cavity 25010a, the second cavity 25010b, and the third cavity 25010c. It is the length from the distal end. The proximal to distal length of the triple driver may be 0.1936 inches in a particular example. Other lengths are also envisioned.

The longitudinal offset is configured in various cases to smooth the firing force of the sled during the firing stroke. In various cases, the longitudinal offset O is approximately 25% of the longitudinal length of the triple driver housed within the staple cavity. In other examples, the longitudinal offset O may be less than or greater than 25% of the longitudinal length of the triple driver. For example, a longitudinal offset O of 5% to 35% of the longitudinal length of the triple driver is envisaged. Referring to FIG. 119, a 29.5% longitudinal offset between the first pattern 25114 and the second pattern 25116 is utilized, which corresponds to a proximal-to-distal length of 0.1936 inches. corresponds to approximately 0.0573 inch for a triple driver of . In another example, referring to FIG. 120, a 9.2% longitudinal offset between the first pattern 25215 and the second pattern 25216 is utilized, which is 0.1936 inches proximal to distal. This corresponds to approximately 0.0178 inch for a triple driver up to a length of approximately 0.0178 inches. 94-96 show only a portion of each pattern 25014, 25016, 25114, 25115, 25214, 25216, with the same pattern continuing to the distal end of the staple cavity in the particular example.

In certain cases, the triple driver may be triangular, with the driver on one side of the cartridge body not being aligned with the driver on the opposite side of the cartridge body. The asymmetric placement of the triple driver within the cartridge body may allow the thread to be asymmetric with respect to the longitudinal centerline. In such a case, one side of the cartridge body can have additional space at the proximal end and that side of the driver is longitudinally offset in the distal direction. Additional space may accommodate lockout components and/or rotating driver supports. Exemplary lockout and rotating driver supports are described further herein. In certain examples, the lockout component and the rotary drive support may be at least partially aligned at the proximal end of the cartridge body.

In other examples, the sled rails may be longitudinally offset to balance firing forces. For example, the sled rail(s) on a first side of the sled may extend by 25% of the longitudinal length of the triple driver housed within the cartridge body 25002, and the sled rail(s) on the opposite side of the sled may be longitudinally offset from.

Referring again to FIG. 94, in certain examples, the longitudinal rows 25012a, 25012b, 25012c on each side 25002a, 25002b may be laterally spaced differently. For example, the inner row 25012a and the middle row 25012b on the second cartridge side 25002b are closer to each other than the inner row 25012a and the middle row 25012b on the first cartridge side 25002a. The distance between axis 25024 and axis 25025 is, for example, smaller than the distance between axis 25022 and axis 25023. Further, the outer row 25012c and middle row 25012b on the second cartridge side 25002b are further apart than the outer row 25012c and middle row 25012b on the first cartridge side 25002a. The distance between axis 25026 and axis 25025 is, for example, greater than the distance between axis 25021 and axis 25022. Further, on each side of the cartridge body 25002, the lateral spacing between the inner row 25012a and the middle row 25012b is different than the lateral spacing between the middle row 25012c and the outer row 25012c.

In other examples, none of the rows of staple patterns on one side of the cartridge body (eg, on one side of the longitudinal knife slot) may be a repeating pattern. The unique, non-repetitive pattern in each row allows for row-by-row customization to ensure the maximum number of staple cavities fit within the cartridge body, especially in the proximal region near the tissue stop. can. Furthermore, in certain cases, the staple pattern may utilize the same driver, eg, the same triple driver, along the entire length of the staple line. In such instances, only a single type of driver is utilized within the staple cartridge, which can improve the manufacturing process. In certain examples, the most proximal and/or most distal fastener cavities of the inner and outer rows may be offset, for example.

Referring now to FIG. 121, staple cartridge 25300 has a cartridge body 25302 and a staple cavity 25310 defined within cartridge body 25302. Staple cavity 25310 is sized and configured to retain a driver and staple therein, as further described herein. A longitudinal slot 25306 divides the cartridge body 25302 into a first side 25302a and a second side 25302b. The staple cavities 25010 are arranged in two patterns: a first pattern 25314 on the first side 25002a of the longitudinal slot 25306, and a second pattern 25316 on the second side 25302b of the longitudinal slot 25006. Ru. Each pattern 25315 includes an inner row 25012a, a middle row 25012b, and an outer row 25012c. The first pattern 25014 is the same as the second pattern (eg, a symmetrical mirror image about the longitudinal axis L). FIG. 97 shows only a portion of each pattern 25314, 25316, with the same pattern continuing to the distal end of the staple cavity in the particular example.

In the first and second patterns 25314, 25316, the most proximal staple cavity 24310a is longitudinally offset from the second most proximal staple cavity 25310b by a first distance or longitudinal offset O1. Additionally, in the first and second patterns 25314, 25316, the second-proximal staple cavity 24310b is longitudinally offset from the third-proximal staple cavity 25310c by a second distance or longitudinal offset O2. be done. The first longitudinal offset O1 is less than 50% of the staple crown lengths L1, L2, and L3 of the staples in the inner row 25012a, middle row 25012b, and outer row 25012c, respectively. A second longitudinal offset O2 is selected based on longitudinal offset O1 to alternate staples fired from the middle row 25012c with respect to staples fired from the inner row 25012a and the outer row 25012c. Stated another way, the second longitudinal offset O2 is selected to provide at least a small degree of longitudinal overlap between the columns. The second longitudinal offset O2 is greater than the first longitudinal offset O1.

With further reference to patterns 25314, 25316, the columns 25312a, 25312b, 25312c on each side 25002a, 25002b are different from the other columns on that side. More specifically, the number of cavities and the spacing between cavities are the same; however, the starting positions of columns 25312a, 25312b, 25312c are different.

Furthermore, each row 25312a, 25312b, 25312c extends along an axis parallel to the longitudinal axis L. The lateral spacing of the rows 25312a, 25312b, 25312c, ie the spacing of the axes along which the rows extend, may be different. For example, on both sides 25302a, 25302b, the lateral spacing between the inner row 25312a and the middle row 25312b is less than the lateral spacing between the middle row 25312b and the outer row 25312c.

In certain cases, rows on the same side 25002a, 25002b can be configured to receive different staples and/or have molded pockets configured to form staples into different sizes and/or shapes. Can be aligned. For example, on the same side 25002a, 25002b, but in different rows, certain staples may be larger than staples in other rows and/or formed to a higher formed height than staples in other rows. It may be configured so that Additionally or alternatively, staples from the same side 25002a, 25002b may be formed into a 2D planar configuration, while staples on the same side 25002a, 25002b are configured to be formed into a 3D non-planar staple. be done.

As described further herein, the triple driver includes three staple struts connected by a bridge. In various cases, staple patterns 25314 and 25316 may be fired exclusively with the triple driver. Stated another way, a single type of driver can fire all staples from patterns 25314, 25316.

Other staple patterns with non-identical rows are also envisioned. For example, in certain instances, the inner and outer rows may be symmetrical with respect to the middle row, with the most proximal cavity and/or the cavity being positioned closer to each other to accommodate the tissue stop. In such an example, the inner and outer rows have some staples that are longitudinally aligned between the rows and other staples that are not longitudinally aligned between the rows. In other examples, one of the rows may have fewer staples than the other row. For example, the outer row can have fewer staples that are further spaced apart longitudinally.

Referring now to FIG. 122, two staple cartridges 25400 and 25500 are shown side by side for comparison purposes. Staple cartridges 25400, 25500 each include a cartridge body 25402, 25502, and three rows of staple cavities 25410, 25510, respectively, on each side of longitudinal direction A. Staple cartridges 25400, 25500 are similar in many aspects to various staple cartridges described herein.

Each staple cartridge 25400, 25500 also includes a datum 25408, 25508, respectively, corresponding to the distal end of the tissue stop. When the clinician first places the target tissue between the anvil and the staple cartridge, it is important that the knife is positioned so that it does not cut into the target tissue until the target tissue is first stapled. A tissue stop can be provided at the proximal end of the anvil body to prevent target tissue from migrating proximally beyond the most proximal staple pocket within the staple cartridge.

In certain cases, the cartridge body may include at least one summed or combined staple length on each side of the longitudinal axis A proximal to the tissue stop. The combined staple length is the sum of the lengths of one or more staples or portions thereof placed proximal to the tissue stop. The sum of these individual lengths equals the combined staple length. For example, referring to staple cartridge 25400, one full staple and two half staples are proximal to the tissue stop relative to the combined staple length of the two staples. However, because at least one combined staple length is desired to be proximal to the tissue stop datum 25408, there is little room to shift the tissue stop datum 25408 proximally.

Conversely, with reference to staple cartridge 25500, the tissue stop is at a more proximal location relative to the proximal end of staple cartridge 25500 and the most proximal fastener cavity. Additionally, the combined staple length on each side of the cartridge body still meets at least one combined staple length target proximal to the tissue stop datum 25508. At the proximal end of the staple cavity pattern, the two staple cavities are longitudinally aligned or closely aligned to still maintain the proper combined staple length proximal to the tissue stop. while the tissue stop can be moved proximally.

Various aspects of the subject matter described herein are illustrated in the Examples below.

Example 1 - A body, a fastener removably disposed within the body, and a driver movably supporting the fastener, the driver extending along a longitudinal axis and defining a first width. a first driver comprising a strut, the first strut comprising a first fastener support cradle; and a second strut laterally outwardly from the first strut and defining a second width. a second strut extending between the first strut and the second strut, the second width being different than the first width, the second strut comprising a second fastener support cradle; A fastener cartridge comprising a bridge.

Example 2 - A cavity is defined within the body, the cavity comprising a first lateral guide surface configured to slidably engage the first strut; and a second cavity comprising a second lateral guide surface configured to slidably engage the post.

Example 3 - A first strut includes a first sidewall configured to slidably engage a first lateral guide surface, and a first width is between the first sidewalls. a second sidewall defined, the second post comprising a second sidewall configured to slidably engage the second lateral guide surface, a second width defined between the second sidewalls; The fastener cartridge of Example 2, wherein the fastener cartridge is

Example 4 - The fastener cartridge of any one of Examples 1, 2, and 3, wherein the first width is less than the second width.

Example 5 - A third strut, the first driver being laterally outward from the second strut and defining a third width, the third width being different than the second width; Examples 1 and 2 further comprising a third strut, the third strut comprising a third fastener support cradle, and a second bridge extending between the second strut and the third strut. 5. The fastener cartridge according to any one of , 3, and 4.

Example 6 - The fastener cartridge of Example 5, wherein the third width is intermediate the first width and the second width.

Example 7 - The fastener cartridge of any one of Examples 5 and 6, wherein the first width, second width, and third width are different widths.

Example 8 - further comprising a sled configured to move along a longitudinal axis during a firing stroke, the sled configured to drivingly engage the central portion aligned with the longitudinal axis and the bridge. and a second rail configured to drivingly engage the second bridge. .

Example 9 - The fasteners are arranged in longitudinal rows, the longitudinal rows being spaced laterally outwardly from the first row by a distance from the first row comprising the first fasteners, and the longitudinal rows comprising a first fastener. a second row comprising two fasteners, and a third row spaced laterally outwardly from the second row by the distance and comprising a third fastener; A fastener support cradle is configured to support the first fastener, a second fastener support cradle is configured to support the second fastener, and a third fastener support cradle is configured to support the second fastener. 9. The fastener cartridge of any one of Examples 5, 6, 7, and 8, wherein the fastener cartridge is configured to support three fasteners.

Example 10 - further comprising a rotary drive screw extending distally beyond the plurality of fasteners along the longitudinal axis, the first strut being adjacent to the rotary drive screw, the first strut extending distally beyond the plurality of fasteners; The fastener cartridge of any one of Examples 1, 2, 3, 4, 5, 6, 7, 8, and 9, comprising a base with a chamfered edge configured to receive the fastener cartridge.

Example 11 - Examples 1, 2, 3, 4, 5, 6, 7, 8, 9, and further comprising a laterally curved tissue support surface, the laterally curved tissue support surface comprising a peak. 10. The fastener cartridge according to any one of 10.

Example 12 - As described in Example 11, wherein the first strut is adjacent the peak of the laterally curved tissue support surface and the first driver comprises a gusset extending between the bridge and the first strut. fastener cartridge.

Example 13 - A driver for movably supporting a body, a fastener removably disposed within the body, and a fastener extending along a longitudinal axis, the driver comprising a first driver. , a first driver includes a first strut defining a first width, a second strut laterally outwardly from the first strut, a second strut defining a second width, and a second strut laterally outwardly from the second strut; a third strut that is outward in the direction and defines a third width, the first width, the second width, and the third width being different widths; a fastener cartridge comprising: a driver comprising; and a fastener cartridge comprising:

Example 14 - The fastener cartridge of Example 13, wherein the first width is less than the second width and the third width.

Example 15 - The fastener cartridge of Example 14, wherein the second width is greater than the third width.

Example 16 - The first driver is a first bridge extending between a first strut and a second strut, the first bridge comprising a first sloped lower surface. further comprising a bridge and a second bridge extending between the second strut and the third strut, the second bridge comprising a second sloped lower surface; The fastener cartridge according to any one of Examples 13, 14, and 15.

Example 17 - further comprising a sled configured to move along a longitudinal axis during a firing stroke, the sled having a central portion aligned with the longitudinal axis and a drive engagement with the first sloped lower surface. 17. The fastener cartridge of Example 16, comprising a first rail configured to mate with the second rail and a second rail configured to drivingly engage the second sloped lower surface.

Example 18 - further comprising a rotary drive screw extending along the longitudinal axis, the first post being adjacent to the rotary drive screw, the first post being chamfered and configured to receive the rotary drive screw. 18. The fastener cartridge of any one of Examples 13, 14, 15, 16, and 17, comprising a base with an edge.

Example 19 - Fasteners are arranged in longitudinal rows, the longitudinal rows being a first row extending along a first row axis, the first row being supported by a first strut. and a second row extending along a second row axis, the second row comprising a first fastener supported by a second column. a second row with fasteners, and a third row extending along the third row axis, the third row with a third fastener supported by a third strut; and a third column, wherein the second column axis is equidistantly spaced from the first column axis and the third column axis. The fastener cartridge according to any one of the above.

Example 20 - a body extending along a longitudinal axis, an inner row on a first side of the longitudinal axis, the first side comprising an inner fastener; an intermediate row on a first side of the longitudinal axis, the intermediate row comprising an intermediate fastener; and an outer row on a first side of the longitudinal axis, the outer row comprising an outer fastener; an outer row, the rows being spaced equidistantly from the inner and outer rows; a triple driver comprising: a row of fasteners; an inner post defining a first width and configured to support an inner fastener; an inner post defining a second width; an intermediate post configured to support an intermediate fastener; and an outer post defining a third width. a triple driver; and an outer post configured to support an outer fastener, the first width being less than the second width and the third width. .

Example 21 - A body with a tissue support deck, a fastener cavity defined through the tissue support deck within the body, the fastener cavity comprising a first cavity, the tissue support deck having a tissue-opposed side; a fastener removably disposed within the fastener cavity; a driver configured to movably support a fastener and move the fastener through a portion of the fastener cavity to a firing position to eject the fastener from the fastener cavity; a first driver comprising: a post comprising a fastener cradle; a base extending laterally from the post; an upper surface configured to mate with the lower surface profile when the first driver is in a firing position; A fastener cartridge comprising: a base comprising a contour; and a driver comprising a contour.

Example 22 - The fastener of Example 21, wherein the lower surface profile comprises a recess and the upper surface contour comprises a protrusion configured to nest within the recess when the first driver is in the firing position. cartridge.

Example 23 - Any one of Examples 21 and 22, wherein the fastener cavity comprises an opening in the tissue-facing side, and the tissue-facing side comprises a ridge extending around at least a portion of the opening. Fastener cartridge as described in.

Example 24 - The fastener cartridge of Example 23, wherein the ridge comprises a first ridge with a laterally varying height.

Example 25 - The fastener cartridge of any one of Examples 23 and 24, wherein the ridge spans at least two openings across adjacent rows of fastener cavities.

Example 26 - The strut comprises a first strut, the first driver further comprises a second strut laterally offset from the first strut, and the base is connected to the first strut and the second strut. 26. The fastener cartridge of any one of Examples 21, 22, 23, 24, and 25 forming a bridge with the post, the top of the bridge comprising a top profile.

Example 27 - further comprising a sled with a sled rail configured to move along a firing path during a firing stroke for driving engagement with the first driver, the top of the bridge being positioned relative to the firing path. 27. The fastener cartridge of Example 26, wherein the fastener cartridge is asymmetric.

Example 28 - The fastener cartridge of Example 27, wherein the first driver is overdriven by the sled to a firing position in which the fastener cradle extends from the fastener cartridge beyond the tissue support deck.

Example 29 - The bridge comprises a first bridge, the fastener cavity further comprises a second cavity, the underside further comprises a second underside profile adjacent the first cavity, and the first driver comprises a second underside profile adjacent to the first cavity. a third strut laterally offset from the first strut and the second strut, and a second bridge between the second strut and the third strut, the top surface of the second bridge comprising: the fastener of Example 26, further comprising a second bridge comprising a second upper surface contour configured to mate with the second lower surface contour when the first driver is in the firing position. utensil cartridge.

Example 30 - a first sled rail further comprising a sled, the sled configured to move along a first firing path and drivingly engage the first bridge during a firing stroke; a second sled rail configured to move along the second firing path into driving engagement with the second bridge, the top of the bridge being asymmetrical with respect to the firing path. , a fastener cartridge as described in Example 29.

Example 31 - A fastener cartridge, the body comprising a tissue support deck, wherein the fastener cavity is defined through the tissue support deck within the body, the tissue support deck having a tissue-facing side with a textured surface. a lower surface opposite the tissue-facing side, the lower surface comprising a grooved surface; a fastener removably disposed within the fastener cavity; and moving the fastener. a driver configured to support and move through a portion of the fastener cavity to a firing position for ejecting a fastener from the fastener cavity, each driver being housed within a fastener cartridge; a fastener cartridge comprising: a base having a surface contour configured to mate with a grooved surface on a lower surface of a tissue support deck when each driver is in a firing position;

Example 32 - The fastener cartridge of Example 31, wherein the grooved surface comprises a plurality of recesses and the surface profile is configured to nest within the recess when the driver is in the firing position. .

Example 33 - Any one of Examples 31 and 32, wherein the fastener cavity comprises an opening in the tissue-facing side, and the tissue-facing side comprises a ridge extending around at least a portion of the opening. Fastener cartridge as described in.

Example 34 - The fastener cartridge of any one of Examples 31, 32, and 33, wherein the ridge spans at least two openings across laterally spaced rows of fastener cavities.

Example 35 - Each driver is a first strut, a second strut laterally offset from the first strut, and a bridge extending between the first strut and the second strut, Any of Examples 31, 32, 33, and 34, comprising a bridge, wherein an upper portion of the bridge comprises a surface contour configured to mate with a grooved surface on a lower surface of the tissue support deck. The fastener cartridge according to one.

Example 36 - further comprising a sled comprising a sled rail configured to move along the firing path during a firing stroke to drivingly engage the at least one driver, the top of each bridge along the firing path The fastener cartridge of Example 35, wherein the fastener cartridge is asymmetric with respect to the firing path.

Example 37 - The fastener cartridge of Example 36, wherein the driver is overdriven by the sled to a firing position in which a portion of the driver extends beyond the tissue support deck.

Example 38 - A fastener cartridge, the body comprising a tissue support deck, the fastener cavity being defined through the tissue support deck within the body, the tissue support deck having a tissue-facing side comprising an array of protrusions. a body, a fastener removably disposed within the fastener cavity, and a contoured lower surface opposite the tissue-facing side, movably supporting the fastener; a first fastener configured to move through a portion of the cavity to a firing position to eject a fastener from the fastener cavity, each driver defining a first longitudinal axis; a first strut with a cradle; a second strut with a second fastener cradle defining a second longitudinal axis; and a bridge connecting the first strut and the second strut within the body. a fastener comprising: a driver; a bridge; cartridge.

Example 39 - The fastener cartridge of Example 38, wherein the at least one bridge comprises a laterally sloped upper surface configured to complement a portion of the contoured lower surface.

Example 40 - The fastener cartridge of Example 38, wherein the at least one bridge comprises a contoured upper surface configured to complement a portion of the contoured lower surface.

Example 41 - A fastener cartridge comprising a cartridge body with an alignment surface and a lug, a fastener removably disposed within the cartridge body, a driver movably supporting the fastener, and a fastener cartridge comprising: a channel dimensioned to receive the channel, the channel having a sidewall, the sidewall having a notch dimensioned to receive the lug, and a longitudinal stop, the notch having an alignment surface; a stapling assembly comprising: a channel aligned with a lug on the cartridge body when levered against the longitudinal stop;

Example 42 - A channel includes a first sidewall and a second sidewall, the channel is dimensioned to receive a fastener cartridge between the first sidewall and the second sidewall, and includes a notch and a longitudinal 42. The stapling assembly of Example 41, wherein a directional stop is defined in the first sidewall.

Example 43 - The stapling assembly of Example 42, wherein the notch is located distal to the longitudinal stop in the first sidewall.

Example 44 - The stapling assembly of any one of Examples 41, 42, and 43, wherein the longitudinal stop comprises a curved abutment surface against which the cartridge body is levered during an insertion operation.

Example 45 - The longitudinal stop comprises a first longitudinal stop, the notch comprises a first notch, and the second sidewall comprises a second longitudinal stop and a second longitudinal stop. and a second notch longitudinally offset from the stapling assembly of any one of Examples 42 and 43.

Example 46 - the registration surface comprises a first registration surface, the lug comprises a first lug, the cartridge body further comprises a second registration surface and a second lug, the second registration surface 46. The stapling assembly of Example 45, wherein the second notch is aligned with the second lug when the surface abuts the second longitudinal stop.

Example 47 - The notch includes a proximal upright surface and a distal upright surface, and the lug is dimensioned to fit between the proximal upright surface and the distal upright surface, and the lug is dimensioned to fit between the proximal upright surface and the distal upright surface. The stapling assembly of any one of Examples 41, 42, 43, 44, 45, and 46, wherein the stapling assembly is non-parallel to the upright plane.

Example 48 - further comprising a spring, the distal upright surface comprising a sloped surface, the lug comprising a sloped distal end, and the spring having a sloped distal end when the fastener cartridge is installed in the channel. 48. The stapling assembly of Example 47, wherein the stapling assembly is configured to bias the portion into mating contact with the ramp.

Example 49 - When the alignment surface abuts the longitudinal stop and the fastener cartridge moves toward installation within the channel, the spring compresses between the proximal upright surface and the proximal end of the lug. 49. The stapling assembly of Example 48, wherein the stapling assembly is

Example 50 - The stapling assembly according to any one of Examples 48 and 49, wherein the spring comprises a leaf spring.

Example 51 - Any of Examples 48, 49, and 50, wherein the spring is arranged and configured to bias the fastener cartridge distally relative to the channel into a fully seated position. A stapling assembly as described in or.

Example 52 - further comprising a firing element configured to move distally through the fastener cartridge during a firing stroke, the firing element moving the fastener cartridge distally relative to the channel during the firing stroke. according to any one of Examples 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, and 51, configured to be biased to a fully seated position. stapling assembly.

Example 53 - The cartridge body further comprises a laterally extending pin, the channel further comprises a slot dimensioned to receive the laterally extending pin upon insertion of the fastener cartridge into the channel, the slot 53. The stapling assembly of Example 52, wherein the stapling assembly comprises a V-shaped entry portion extending parallel to the direction of insertion of the cartridge body and a second portion extending parallel to the longitudinal axis of the cartridge body.

Example 54 - A fastener cartridge comprising a cartridge body defining a longitudinal axis, the cartridge body comprising a proximal cartridge alignment feature and a distal cartridge alignment feature; a removably disposed fastener, a driver movably supporting the fastener, and a channel dimensioned to receive a fastener cartridge, the channel having a proximal channel alignment mechanism and a proximal channel alignment mechanism; positioning the proximal cartridge alignment feature in abutting engagement with the distal channel alignment feature; and moving the fastener cartridge along the insertion axis to a first position within the channel causes the distal cartridge alignment feature to a distal channel alignment feature disposed to receive the channel, the channel having an insertion axis perpendicular to the longitudinal axis; a spring configured to bias distally from a position to a fully seated position.

Example 55 - The stapling assembly of Example 54, wherein the spring comprises a cantilevered leaf spring.

Example 56 - A spring has a first end attached to a distal cartridge alignment mechanism, a second end opposite the first end, and a first end and a second end. 56. The stapling assembly of any one of Examples 54 and 55, further comprising: an S-bend intermediate the portion.

Example 57 - The cartridge body further comprises a nose, the latch movable between a first position in which the latch secures the nose in the channel and a second position in which the latch releases the nose from the channel; and a user-operated release button configured to move the stapling assembly from the first position to the second position.

Example 58 - The stapling assembly of Example 57, wherein the latch comprises an arm and the channel comprises a distal ledge configured to receive the arm when the latch is in the first position.

Example 59 - A fastener cartridge comprising a cartridge body defining a longitudinal axis, the cartridge body comprising a cartridge alignment profile and a lug, and a fastener removably disposed on the cartridge body. , a driver movably supporting a fastener, and a channel dimensioned to receive a fastener cartridge, the channel having a channel alignment profile and a cartridge alignment profile tangent to the channel alignment profile. a channel, the channel having a side wall having a notch arranged to receive the lug upon positioning and movement of the fastener cartridge into the channel along the insertion axis, the insertion axis being perpendicular to the longitudinal axis; and a stapling assembly, the lug being configured to shift distally within the notch to a fully seated position upon installation of the fastener cartridge within the channel.

Example 60 - As the fastener cartridge moves into the channel along the insertion axis, the cartridge body is levered against the channel alignment contour and the biasing element fully seats the lugs in the notches. 60. The stapling assembly of Example 59, wherein the stapling assembly is arranged to bias distally to the position.

Example 61 - A cartridge body comprising a tissue support deck, the cartridge body having a longitudinal axis extending therethrough, and an inner fastener defined within the cartridge body through the tissue support deck. an inner fastener cavity, the inner fastener cavities being arranged in an inner longitudinal row on a first side of the longitudinal axis, the inner longitudinal row comprising an inner most proximal fastener cavity; intermediate fastener cavities defined within the cartridge body through the tissue support deck, the intermediate fasteners being arranged in an intermediate longitudinal row on a first side of the longitudinal axis and comprising an intermediate proximal most fastener cavity; and an outer fastener cavity defined within the cartridge body through the tissue support deck, the outer fastener cavities being disposed in an outer longitudinal row on a first side of the longitudinal axis and comprising an outer most proximal fastener cavity. an outer fastener cavity, a driver disposed within the inner fastener cavity, the intermediate fastener cavity, and the outer fastener cavity, and a fastener supported by the driver, each fastener having a proximal end and a driver disposed within the outer fastener cavity; a crown with a distal end, a proximal leg extending from the proximal end, and a distal leg extending from the distal end, the crown having an inner longitudinal row, an intermediate longitudinal row, and an outer longitudinal row. and a fastener defining a uniform length across the longitudinal row, wherein the inner most proximal fastener cavity, the middle most proximal fastener cavity, and the outer most proximal fastener cavity are longitudinally offset and the inner most proximal fastener cavity defines a uniform length across the longitudinal row. A linear fastener cartridge, wherein the proximal fastener cavity is longitudinally offset from the outer most proximal fastener cavity by a longitudinal length that is less than half the uniform length of the crown.

Example 62 - The inner fastener cavities in the inner longitudinal row are longitudinally spaced apart a first distance, the intermediate fastener cavities in the middle longitudinal row are longitudinally spaced a second distance, and Described in Example 61, wherein the outer fastener cavities in the outer longitudinal row are longitudinally spaced apart by a third distance, and the first distance, the second distance, and the third distance are the same distance. linear fastener cartridge.

Example 63 - An implementation in which the inner longitudinal row, middle longitudinal row, and outer longitudinal row have the same number of fastener cavities, and each row is laterally offset from the other rows by a different amount. A linear fastener cartridge according to any one of Examples 61 and 62.

Example 64 - The inner longitudinal row is laterally spaced a first lateral distance from the intermediate longitudinal row, and the intermediate longitudinal row is laterally spaced a second lateral distance from the outer longitudinal row. 62. The linear fastener cartridge of Example 61, wherein the linear fastener cartridge is spaced apart, and the first lateral distance is different than the second lateral distance.

Example 65 - The linear fastener cartridge of any one of Examples 61 and 64, wherein the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row are different from each other.

Example 66 - The linear fastener cartridge of Example 65, wherein the tissue support deck is symmetrical about the longitudinal axis.

Example 67 - The fasteners in the inner longitudinal row define a first unformed height, the fasteners in the middle longitudinal row define a second unformed height, and the fasteners in the inner longitudinal row define a second unformed height. the fastener within defines a third unformed height, and at least one of the first unformed height, the second unformed height, and the third unformed height. The linear fastener cartridge of any one of Examples 61, 62, 63, 64, 65, and 66, wherein the linear fastener cartridge is different.

Example 68 - The fasteners in the inner longitudinal row are configured to exhibit a first formed height and the fasteners in the middle longitudinal row are configured to exhibit a second formed height. and the fasteners in the outer longitudinal row are configured to exhibit a third formed height, the first formed height, the second formed height, and the third formed height. 68. The linear fastener cartridge of any one of Examples 61, 62, 63, 64, 65, 66, and 67, wherein at least one of the heights is different.

Example 69 - A cartridge body comprising a tissue support deck, the cartridge body having a longitudinal axis extending through the cartridge body and a cartridge body with a tissue support deck extending through the tissue support deck on a first side of the longitudinal axis. a first array of fastener cavities defined within the body, the first array of fastener cavities comprising a first most proximal fastener cavity and tissue support on a second side of the longitudinal axis; a second array of fastener cavities defined through the deck and into the cartridge body, the second array of fastener cavities comprising a second most proximal fastener cavity; each fastener comprising a crown, a proximal leg extending from the crown, a distal leg extending from the crown, and a driver supporting the fastener, each driver having an inner post; a driver comprising an intermediate strut, an outer strut, a first bridge connecting the inner strut and the intermediate strut, and a second bridge connecting the intermediate strut and the outer strut; A linear fastener cartridge, wherein the most proximal fastener cavity is longitudinally offset a distance from the second most proximal fastener cavity.

Example 70 - The linear fastener cartridge of Example 69, wherein the first array of fastener cavities and the second array of fastener cavities comprise the same number of fastener cavities.

Example 71 - The linear fastener cartridge of Example 70, wherein the first array of fastener cavities and the second array of fastener cavities comprise the same pattern.

Example 72 - A longitudinal driver length is defined between the most proximal and most distal legs supported by the same driver, and the distance is less than 50% of the longitudinal driver length. 72. The linear fastener cartridge of any one of Examples 69, 70, and 71, wherein:

Example 73 - The linear fastener cartridge of Example 72, wherein the distance is about 25% of the longitudinal driver length.

Example 74 - The linear fastener cartridge of Example 72, wherein the distance is about 10% of the longitudinal driver length.

Example 75 - A cartridge body comprising a tissue support deck, the cartridge body having a longitudinal axis extending through the cartridge body and an inner longitudinal axis of a fastener cavity on a first side of the longitudinal axis. an intermediate longitudinal row of fastener cavities on a first side of the longitudinal axis, the intermediate longitudinal row of fastener cavities defining an intermediate axis parallel to the longitudinal axis; an outer longitudinal row of fastener cavities on a first side of the shaft, the inner longitudinal row of fastener cavities and the outer longitudinal row of fastener cavities being asymmetric with respect to the intermediate axis; a triple driver spanning an outer longitudinal row of cavities, an inner longitudinal row of fastener cavities, an intermediate longitudinal row of fastener cavities, and an outer longitudinal row of fastener cavities, and a fastener supported by the triple driver; each fastener includes a crown with a proximal end and a distal end, a proximal leg extending from the proximal end, and a distal leg extending from the distal end; A linear fastener cartridge comprising: a fastener defining a uniform length across an inner longitudinal row, an intermediate longitudinal row, and an outer longitudinal row.

Example 76 - The outer longitudinal row of fastener cavities comprises an outer fastener cavity with a first proximal end, and the inner longitudinal row of fastener cavities comprises a second proximal end. a first inner fastener cavity, the first inner fastener cavity having a first proximal end and a second proximal end longitudinally aligned; and a third proximal end. a second inner fastener cavity comprising portions, the third proximal end being longitudinally staggered with respect to the proximal ends of all fastener cavities in the outer longitudinal row of fastener cavities; and a second inner fastener cavity disposed in the linear fastener cartridge of Example 75.

Example 77 - The linear fastener cartridge of any one of Examples 75 and 76, wherein the inner longitudinal row of fastener cavities is the same length as the outer longitudinal row of fastener cavities.

Example 78 - The linear fastener cartridge of any one of Examples 75, 76, and 77, wherein the inner longitudinal row of fastener cavities comprises more fastener cavities than the outer longitudinal row.

Example 79 - Example 75, wherein the outer longitudinal row comprises a third fastener cavity staggered longitudinally with respect to all other fastener cavities on the first side of the longitudinal axis; 79. The linear fastener cartridge of any one of 76, 77, and 78.

Example 80 - The inner fastener cavities in the inner longitudinal row are longitudinally spaced apart a first distance, the intermediate fastener cavities in the intermediate longitudinal row are longitudinally spaced a second distance, and The outer fastener cavities in the outer longitudinal row are longitudinally spaced apart by a third distance, and at least one of the first distance, the second distance, and the third distance is different from the other. The linear fastener cartridge of any one of Examples 75, 76, 77, 78, and 79, wherein the linear fastener cartridge is different.

Many of the surgical instrument systems described herein are powered by electric motors. However, the surgical instrument systems described herein may be driven in any suitable manner. In various instances, the surgical instrument systems described herein can be driven by a manually operated trigger, for example. In certain examples, the motors disclosed herein may comprise one or more parts of a robotically controlled system. Additionally, any of the end effectors and/or tool assemblies disclosed herein can be utilized with robotic surgical instrument systems. For example, U.S. patent application Ser. The Disclosed in more detail.

Although the surgical instrument systems described herein have been described in connection with staple placement and deformation, the embodiments described herein are not so limited. For example, various embodiments are envisioned that place fasteners other than staples, such as clamps or tacks. Additionally, various embodiments are envisioned that utilize any suitable means for sealing tissue. For example, an end effector according to various embodiments can include an electrode configured to heat and seal tissue. Similarly, for example, an end effector according to certain embodiments can apply vibrational energy to seal tissue.

The entire content of the following disclosure is incorporated herein by reference.
- U.S. Patent No. 5,403,312, issued on April 4, 1995, entitled "ELECTROSURGICAL HEMOSTATIC DEVICE";
- U.S. Patent No. 7,000,818, issued February 21, 2006, entitled "SURGICAL STAPLING INSTRUMENT HAVING SEPARATE DISTINCT CLOSING AND FIRING SYSTEMS";
- U.S. Patent No. 7,422,139, issued September 9, 2008, title: "MOTOR-DRIVEN SURGICAL CUTTING AND FASTENING INSTRUMENT WITH TACTILE POSITION FEEDBACK";
-A US Patent No. 7,464,849, published on December 16, 2008, the name of the invention, "ELECTRO -MECHANICAL SURGICAL INSTRUMENT WITH CLOSURE SYSTEM And Anvil ANVIL ANVIL ALIGNMENT COMPO NENTS ",
- U.S. Patent No. 7,670,334, issued on March 2, 2010, entitled "SURGICAL INSTRUMENT HAVING AN ARTICULATING END EFFECTOR";
- U.S. Patent No. 7,753,245, issued July 13, 2010, entitled "SURGICAL STAPLINING INSTRUMENTS";
- U.S. Patent No. 8,393,514, issued March 12, 2013, title of the invention "SELECTIVELY ORIENTABLE IMPLANTABLE FASTENER CARTRIDGE";
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser. No. 45),
- U.S. patent application Ser. BLY” (now U.S. Pat. No. 8,220,688) ),
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
- U.S. patent application Ser.
U.S. patent application Ser.
- U.S. Patent Application Publication No. 2007/0175955, filed on January 31, 2006, title of the invention "SURGICAL CUTTING AND FASTENING INSTRUMENT WITH CLOSURE TRIGGER LOCKING MECHANISMS", and -20 U.S. Patent Application Publication No. filed April 22, 2010 No. 2010/0264194, entitled "SURGICAL STAPLING INSTRUMENT WITH AN ARTICULATABLE END EFFECTOR" (currently US Pat. No. 8,308,040).

Although various devices are described herein with particular embodiments, modifications and changes may be made to those embodiments. The particular features, structures or characteristics may be combined in any suitable manner in one or more embodiments. Thus, a particular feature, structure, or characteristic illustrated or described with respect to one embodiment may, without limitation, be combined in whole or in part with the feature, structure, or characteristic of one or more other embodiments. It's okay. Also, although materials are disclosed for particular components, other materials may be used. Further, a single component may be replaced by multiple components, and multiple components may be replaced by a single component to perform a given function, according to various embodiments. . The foregoing description and the following claims are intended to cover all such modifications and variations.

The devices disclosed herein can be designed to be discarded after a single use, or can be designed to be used multiple times. However, in any case, the device can be reconditioned for reuse after at least one use. Reconditioning can include, but is not limited to, any combination of disassembling the device, followed by cleaning or replacing certain parts of the device, and subsequent reassembly of the device. Specifically, the reconditioning facility and/or surgical team may disassemble the device, clean and/or replace certain parts of the device, and then reassemble the device for subsequent use. Can be done. Those skilled in the art will appreciate that reconditioning the device can utilize a variety of techniques for disassembly, cleaning/replacement, and reassembly. The use of such techniques, and the resulting reconditioned devices, are all within the scope of this application.

The devices disclosed herein may be processed prior to surgery. Initially, new or used instruments may be obtained and cleaned as necessary. The instrument can then be sterilized. In one sterilization technique, instruments are placed in closed, sealed containers, such as plastic bags or TYVEK bags. The container and device can then be placed in a field of radiation that can penetrate the container, such as gamma rays, x-rays, and/or high-energy electrons. Radiation can kill bacteria on instruments and in containers. After this, the sterilized instruments can be stored in a sterile container. The sealed container can keep the instrument sterile until opened at a medical facility. The device may also be sterilized using any other technique known in the art, including, but not limited to, beta radiation, gamma radiation, ethylene oxide, hydrogen peroxide plasma, and/or water vapor.

While the invention has been described as having a representative design, the invention may be further modified within the spirit and scope of this disclosure. This application is therefore intended to cover any variations, uses, or adaptations of the invention using its general principles.

Any patent, publication, or other disclosure document that is incorporated by reference in whole or in part into this specification does not include any prior definitions, views, or other disclosures in which the incorporated material is set forth in this disclosure. It is incorporated herein only to the extent consistent with the content thereof. As such, and to the extent necessary, disclosure expressly set forth herein shall supersede any conflicting description incorporated herein by reference. Any material, or portion thereof, that is cited as being incorporated herein by reference but is inconsistent with current definitions, views, or other disclosures set forth herein shall be deemed to be incorporated by reference. They are incorporated only to the extent that they are consistent with existing disclosures.

[Mode of implementation]
(1) A linear fastener cartridge,
a cartridge body comprising a tissue support deck, the longitudinal axis extending through the cartridge body;
an inner fastener cavity defined within the cartridge body through the tissue support deck, the inner fastener cavity being disposed in an inner longitudinal row on a first side of the longitudinal axis; an inner fastener cavity, the longitudinal row comprising an inner most proximal fastener cavity;
an intermediate fastener cavity defined within the cartridge body through the tissue support deck, the intermediate fastener cavity being disposed in an intermediate longitudinal row on the first side of the longitudinal axis; an intermediate fastener cavity, the intermediate longitudinal row comprising an intermediate most proximal fastener cavity;
an outer fastener cavity defined within the cartridge body through the tissue support deck, the outer fastener cavity being disposed in an outer longitudinal row on the first side of the longitudinal axis; an outer fastener cavity, the outer longitudinal row comprising an outer most proximal fastener cavity;
a driver disposed in the inner fastener cavity, the intermediate fastener cavity, and the outer fastener cavity;
A fastener supported by the driver, each fastener comprising a crown having a proximal end and a distal end, a proximal leg extending from the proximal end, and a proximal leg extending from the proximal end. a distal leg extending from the top of the fastener, the crown defining a uniform length across the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row;
The inner most proximal fastener cavity, the intermediate most proximal fastener cavity, and the outer most proximal fastener cavity are longitudinally offset such that the inner most proximal fastener cavity is of the uniform length of the crown. A linear fastener cartridge that is longitudinally offset from said outer most proximal fastener cavity by a longitudinal length that is less than one-half.
(2) the inner fastener cavities in the inner longitudinal row are longitudinally spaced apart a first distance, and the intermediate fastener cavities in the intermediate longitudinal row are longitudinally spaced a second distance apart; spaced apart, the outer fastener cavities in the outer longitudinal row are longitudinally spaced apart by a third distance, and the first distance, the second distance, and the third distance are the same distance. The linear fastener cartridge of embodiment 1, wherein the linear fastener cartridge is:
(3) the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row have the same number of fastener cavities, each row being laterally offset from the other rows by a different amount; The linear fastener cartridge of embodiment 1, wherein the linear fastener cartridge is of embodiment 1.
(4) the inner longitudinal row is laterally spaced a first lateral distance from the intermediate longitudinal row, and the intermediate longitudinal row is laterally spaced a second lateral distance from the outer longitudinal row; 5. The linear fastener cartridge of embodiment 1, wherein the linear fastener cartridge is spaced apart in a direction, and the first lateral distance is different from the second lateral distance.
5. The linear fastener cartridge of embodiment 1, wherein the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row are different from each other.

(6) The linear fastener cartridge of embodiment 5, wherein the tissue support deck is symmetrical about the longitudinal axis.
(7) the fasteners in the inner longitudinal row define a first unformed height; the fasteners in the intermediate longitudinal row define a second unformed height; The fasteners in the outer longitudinal row define a third unformed height, the first unformed height, the second unformed height, and the third unformed height. The linear fastener cartridge of embodiment 1, wherein at least one of the heights is different.
(8) the fasteners in the inner longitudinal row are configured to exhibit a first formed height, and the fasteners in the intermediate longitudinal row are configured to exhibit a second formed height; wherein the fasteners in the outer longitudinal row are configured to exhibit a third formed height, the first formed height, the second formed height, and the fasteners in the outer longitudinal row configured to exhibit a third formed height; 5. The linear fastener cartridge of embodiment 1, wherein at least one of the formed height and the third formed height are different.
(9) A linear fastener cartridge,
a cartridge body including a tissue support deck, the longitudinal axis extending through the cartridge body;
a first array of fastener cavities defined within the cartridge body through the tissue support deck on a first side of the longitudinal axis, the fastener comprising a first most proximal fastener cavity; a first array of cavities;
a second array of fastener cavities defined within the cartridge body through the tissue support deck on a second side of the longitudinal axis, the fastener comprising a second most proximal fastener cavity; a second array of cavities;
a fastener, each fastener comprising a crown, a proximal leg extending from the crown, and a distal leg extending from the crown;
A driver for supporting the fastener, each driver comprising:
an inner strut,
an intermediate strut;
an outer strut;
a first bridge connecting the inner strut and the intermediate strut;
a driver, comprising: a second bridge connecting the intermediate strut and the outer strut;
A linear fastener cartridge, wherein the first most proximal fastener cavity is longitudinally offset from the second most proximal fastener cavity by a distance.
10. The linear fastener cartridge of embodiment 9, wherein the first array of fastener cavities and the second array of fastener cavities comprise the same number of fastener cavities.

11. The linear fastener cartridge of embodiment 10, wherein the first array of fastener cavities and the second array of fastener cavities comprise the same pattern.
(12) a longitudinal driver length is defined between a most proximal leg and a most distal leg supported by the same driver, the distance being 50% of the longitudinal driver length; 10. The linear fastener cartridge of embodiment 9, wherein the linear fastener cartridge is less than or equal to
13. The linear fastener cartridge of embodiment 12, wherein the distance is about 25% of the longitudinal driver length.
14. The linear fastener cartridge of embodiment 12, wherein the distance is about 10% of the longitudinal driver length.
(15) A linear fastener cartridge, comprising:
a cartridge body including a tissue support deck, the longitudinal axis extending through the cartridge body;
an inner longitudinal row of fastener cavities on a first side of the longitudinal axis;
an intermediate longitudinal row of fastener cavities on the first side of the longitudinal axis, the intermediate longitudinal row of fastener cavities defining an intermediate axis parallel to the longitudinal axis;
an outer longitudinal row of fastener cavities on the first side of the longitudinal axis, the inner longitudinal row of fastener cavities and the outer longitudinal row of fastener cavities relative to the intermediate axis; an outer longitudinal row of fastener cavities that is asymmetrical;
a triple driver spanning the inner longitudinal row of fastener cavities, the intermediate longitudinal row of fastener cavities, and the outer longitudinal row of fastener cavities;
A fastener supported by the triple driver, each fastener comprising a crown having a proximal end and a distal end, a proximal leg extending from the proximal end, and a distal end. a distal leg extending from the top of the linear fastener, the fastener comprising a distal leg extending from the top and the fastener defining a uniform length across the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row. Fastener cartridge.

(16) the outer longitudinal row of fastener cavities comprises:
an outer fastener cavity with a first proximal end, the inner longitudinal row of fastener cavities comprising:
a first inner fastener cavity including a second proximal end, the first proximal end and the second proximal end being longitudinally aligned; an inner fastener cavity;
a second inner fastener cavity including a third proximal end, the third proximal end being proximal to the proximal end of all fastener cavities in the outer longitudinal row of fastener cavities; 16. The linear fastener cartridge of embodiment 15, comprising second inner fastener cavities longitudinally staggered with respect to the ends.
17. The linear fastener cartridge of embodiment 15, wherein the inner longitudinal row of fastener cavities is the same length as the outer longitudinal row of fastener cavities.
18. The linear fastener cartridge of embodiment 15, wherein the inner longitudinal row of fastener cavities comprises more fastener cavities than the outer longitudinal row.
(19) An embodiment in which the outer longitudinal row comprises third fastener cavities staggered longitudinally with respect to all other fastener cavities on the first side of the longitudinal axis. 16. The linear fastener cartridge of claim 15.
(20) the inner fastener cavities in the inner longitudinal row are longitudinally spaced apart a first distance, and the intermediate fastener cavities in the intermediate longitudinal row are longitudinally spaced a second distance apart; spaced apart, the outer fastener cavities in the outer longitudinal row are longitudinally spaced apart a third distance, and at least one of the first distance, the second distance, and the third distance. 16. The linear fastener cartridge of embodiment 15, one different from the others.

Claims (20)

A linear fastener cartridge, the linear fastener cartridge comprising:
a cartridge body comprising a tissue support deck, the longitudinal axis extending through the cartridge body;
an inner fastener cavity defined within the cartridge body through the tissue support deck, the inner fastener cavity being disposed in an inner longitudinal row on a first side of the longitudinal axis; an inner fastener cavity, the longitudinal row comprising an inner most proximal fastener cavity;
an intermediate fastener cavity defined within the cartridge body through the tissue support deck, the intermediate fastener cavity being disposed in an intermediate longitudinal row on the first side of the longitudinal axis; an intermediate fastener cavity, the intermediate longitudinal row comprising an intermediate most proximal fastener cavity;
an outer fastener cavity defined within the cartridge body through the tissue support deck, the outer fastener cavity being disposed in an outer longitudinal row on the first side of the longitudinal axis; an outer fastener cavity, the outer longitudinal row comprising an outer most proximal fastener cavity;
a driver disposed in the inner fastener cavity, the intermediate fastener cavity, and the outer fastener cavity;
A fastener supported by the driver, each fastener comprising a crown having a proximal end and a distal end, a proximal leg extending from the proximal end, and a proximal leg extending from the proximal end. a distal leg extending from the top of the fastener, the crown defining a uniform length across the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row;
The inner most proximal fastener cavity, the intermediate most proximal fastener cavity, and the outer most proximal fastener cavity are longitudinally offset such that the inner most proximal fastener cavity is of the uniform length of the crown. A linear fastener cartridge that is longitudinally offset from said outer most proximal fastener cavity by a longitudinal length that is less than one-half. the inner fastener cavities in the inner longitudinal row are longitudinally spaced apart a first distance; the intermediate fastener cavities in the intermediate longitudinal row are longitudinally spaced a second distance; the outer fastener cavities in the outer longitudinal row are longitudinally spaced apart by a third distance, the first distance, the second distance, and the third distance being the same distance; The linear fastener cartridge of claim 1. wherein said inner longitudinal row, said intermediate longitudinal row, and said outer longitudinal row comprise the same number of fastener cavities, each said row being laterally offset from the other rows by a different amount. The linear fastener cartridge of paragraph 1. the inner longitudinal row is laterally spaced apart from the intermediate longitudinal row by a first lateral distance, and the intermediate longitudinal row is laterally spaced from the outer longitudinal row by a second lateral distance; The linear fastener cartridge of claim 1, wherein the first lateral distance is different than the second lateral distance. The linear fastener cartridge of claim 1, wherein the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row are different from each other. The linear fastener cartridge of claim 5, wherein the tissue support deck is symmetrical about the longitudinal axis. The fasteners in the inner longitudinal row define a first unformed height, the fasteners in the intermediate longitudinal row define a second unformed height, and the fasteners in the inner longitudinal row define a second unformed height, The fasteners in the row define a third unformed height, the first unformed height, the second unformed height, and the third unformed height. 2. The linear fastener cartridge of claim 1, wherein at least one of the fasteners is different. the fasteners in the inner longitudinal row are configured to exhibit a first formed height; and the fasteners in the intermediate longitudinal row are configured to exhibit a second formed height. and the fasteners in the outer longitudinal row are configured to exhibit a third formed height, the first formed height, the second formed height. , and the third defined height are different. A linear fastener cartridge, the linear fastener cartridge comprising:
a cartridge body including a tissue support deck, the longitudinal axis extending through the cartridge body;
a first array of fastener cavities defined within the cartridge body through the tissue support deck on a first side of the longitudinal axis, the fastener comprising a first most proximal fastener cavity; a first array of cavities;
a second array of fastener cavities defined within the cartridge body through the tissue support deck on a second side of the longitudinal axis, the fastener comprising a second most proximal fastener cavity; a second array of cavities;
a fastener, each fastener comprising a crown, a proximal leg extending from the crown, and a distal leg extending from the crown;
A driver for supporting the fastener, each driver comprising:
an inner strut,
an intermediate strut;
an outer strut;
a first bridge connecting the inner strut and the intermediate strut;
a driver, comprising: a second bridge connecting the intermediate strut and the outer strut;
A linear fastener cartridge, wherein the first most proximal fastener cavity is longitudinally offset from the second most proximal fastener cavity by a distance. The linear fastener cartridge of claim 9, wherein the first array of fastener cavities and the second array of fastener cavities comprise the same number of fastener cavities. The linear fastener cartridge of claim 10, wherein the first array of fastener cavities and the second array of fastener cavities comprise the same pattern. a longitudinal driver length is defined between a most proximal leg and a most distal leg supported by the same driver, the distance being less than 50% of the longitudinal driver length; 10. The linear fastener cartridge of claim 9. 13. The linear fastener cartridge of claim 12, wherein the distance is about 25% of the longitudinal driver length. The linear fastener cartridge of claim 12, wherein the distance is about 10% of the longitudinal driver length. A linear fastener cartridge, the linear fastener cartridge comprising:
a cartridge body including a tissue support deck, the longitudinal axis extending through the cartridge body;
an inner longitudinal row of fastener cavities on a first side of the longitudinal axis;
an intermediate longitudinal row of fastener cavities on the first side of the longitudinal axis, the intermediate longitudinal row of fastener cavities defining an intermediate axis parallel to the longitudinal axis;
an outer longitudinal row of fastener cavities on the first side of the longitudinal axis, the inner longitudinal row of fastener cavities and the outer longitudinal row of fastener cavities relative to the intermediate axis; an outer longitudinal row of fastener cavities that is asymmetrical;
a triple driver spanning the inner longitudinal row of fastener cavities, the intermediate longitudinal row of fastener cavities, and the outer longitudinal row of fastener cavities;
A fastener supported by the triple driver, each fastener comprising a crown having a proximal end and a distal end, a proximal leg extending from the proximal end, and a distal end. a distal leg extending from the top of the linear fastener, the fastener comprising a distal leg extending from the top and the fastener defining a uniform length across the inner longitudinal row, the intermediate longitudinal row, and the outer longitudinal row. Fastener cartridge. The outer longitudinal row of fastener cavities is
an outer fastener cavity with a first proximal end, the inner longitudinal row of fastener cavities comprising:
a first inner fastener cavity including a second proximal end, the first proximal end and the second proximal end being longitudinally aligned; an inner fastener cavity;
a second inner fastener cavity including a third proximal end, the third proximal end being proximal to the proximal end of all fastener cavities in the outer longitudinal row of fastener cavities; 16. The linear fastener cartridge of claim 15, comprising second inner fastener cavities longitudinally staggered with respect to the ends. 16. The linear fastener cartridge of claim 15, wherein the inner longitudinal row of fastener cavities is the same length as the outer longitudinal row of fastener cavities. 16. The linear fastener cartridge of claim 15, wherein the inner longitudinal row of fastener cavities comprises more fastener cavities than the outer longitudinal row. 16. The outer longitudinal row comprises third fastener cavities staggered longitudinally with respect to all other fastener cavities on the first side of the longitudinal axis. linear fastener cartridge. the inner fastener cavities in the inner longitudinal row are longitudinally spaced apart a first distance; the intermediate fastener cavities in the intermediate longitudinal row are longitudinally spaced a second distance; The outer fastener cavities in the outer longitudinal row are longitudinally spaced apart by a third distance, and at least one of the first distance, the second distance, and the third distance is 16. The linear fastener cartridge of claim 15, different from the others.

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